Poor Lipid Control in Type-2 Diabetics With and Without Ischemic Heart Disease

King Abdulaziz University, Djidda, Makkah, Saudi Arabia
Endocrine (Impact Factor: 3.88). 08/2003; 21(3):217-20. DOI: 10.1385/ENDO:21:3:217
Source: PubMed


To determine the frequency of type-2 diabetics who have target lipoprotein blood levels, to study these levels in patients with ischemic heart disease and cardiovascular disease risk factors, and to study the possible causes of poor control, we reviewed hyperlipdemic type-2 diabetics who were on regular follow up to the medical outpatient clinic of King Abdulaziz University Hospital from January 2000 to January 2001. A total of 202 patients were studied with mean age of 60 yr and equal male to female ratio. The mean duration of diabetes was 10 yr and it was 7 yr for hyperlipidemia. The mean level of LDL was 3.15 mmol/L and it was 1.0 mmol/L and 2.47 mmol/L for HDL and TG, respectively. Only 31% of patients had LDL < 2.6 mmol/L, 28% had HDL > 1.1 mmol/L, and 37% had TG < 1.7 mmol/L. No significant difference was found in the frequency of target level of LDL in patients with IHD and those without; 26% vs 34% (0.4). Similarly, no difference was found in those with hypertension, obesity, and patients with family history of IHD compared to those without these risk factors; 30%, 26%, 16% vs 34%, 36%, 33% (p = 0.2, 0.1, 0.4, respectively). Males were found to have a higher frequency of target LDL level compared to females; 38% vs 25% (p = 0.04). Poor diet restriction was found in 90% of patients' with poor control, lack of patients' knowledge in 62%, 70% have financial reasons, 86% of patients on multiple medications, and in 16% the treating physician took no proper action. In conclusion, a low frequency of type-2 diabetics have target levels of lipoproteins. Diabetics with IHD and CVD risk factors also have poor lipid control. Poor control was associated with poor diet compliance and use of multiple medications. Proper management and control of this disease is needed among elderly patients.

Download full-text


Available from: Daad H Akbar, Oct 09, 2015
23 Reads
  • Source
    • "High density lipoprotein, total cholesterol and triglyceride levels were also used as measures of lipid control. Thresholds for dyslipidaemia were not consistent, yet where each indicator was used in isolation, rates of dyslipidaemia were: 27.9% [10], 30% [10], 72% [30], 63% [30], 44.6% [15], 44.6% [15], 76.4% [22] and 59.9% [22]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Type 2 diabetes mellitus is a growing, worldwide public health concern. Recent growth has been particularly dramatic in the states of The Co-operation Council for the Arab States of the Gulf (GCC), and these and other developing economies are at particular risk. We aimed to systematically review the quality of control of type 2 diabetes in the GCC, and the nature and efficacy of interventions. We identified 27 published studies for review. Studies were identified by systematic database searches. Medline and Embase were searched separately (via Dialog and Ovid, respectively; 1950 to July 2010 (Medline), and 1947 to July 2010 (Embase)) on 15/07/2009. The search was updated on 08/07/2010. Terms such as diabetes mellitus, non-insulin-dependent, hyperglycemia, hypertension, hyperlipidemia and Gulf States were used. Our search also included scanning reference lists, contacting experts and hand-searching key journals. Studies were judged against pre-determined inclusion/exclusion criteria, and where suitable for inclusion, data extraction/quality assessment was achieved using a specifically-designed tool. All studies wherein glycaemic-, blood pressure- and/or lipid- control were investigated (clinical and/or process outcomes) were eligible for inclusion. No limitations on publication type, publication status, study design or language of publication were imposed. We found the extent of control to be sub-optimal and relatively poor. Assessment of the efficacy of interventions was difficult due to lack of data, but suggestive that more widespread and controlled trial of secondary prevention strategies may have beneficial outcomes. We found no record of audited implementation of primary preventative strategies and anticipate that controlled trial of such strategies would also be useful.
    PLoS ONE 08/2011; 6(8):e22186. DOI:10.1371/journal.pone.0022186 · 3.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Low-density parity-check (LDPC) codes are one of the most promising next generation error correcting codes and many investigations shows that LDPC codes suitable for many hardware implementation. Although randomly constructed LDPC codes are usually encoded by using generator matrix, this method requires quadratic time complexity and is not easy to implement. This work presents the encoding of array-type LDPC codes and a special class of Sridhara-Fuja-Tanner (SFT) codes by division circuits as cyclic codes, which are very easy to implement.
    Information Theory, 2004. ISIT 2004. Proceedings. International Symposium on; 08/2004
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Excess lipid accumulation in the heart is associated with decreased cardiac function in humans and in animal models. The reasons are unclear, but this is generally believed to result from either toxic effects of intracellular lipids or excessive fatty acid oxidation (FAO). PPARγ expression is increased in the hearts of humans with metabolic syndrome, and use of PPARγ agonists is associated with heart failure. Here, mice with dilated cardiomyopathy due to cardiomyocyte PPARγ overexpression were crossed with PPARα-deficient mice. Surprisingly, this cross led to enhanced expression of several PPAR-regulated genes that mediate fatty acid (FA) uptake/oxidation and triacylglycerol (TAG) synthesis. Although FA oxidation and TAG droplet size were increased, heart function was preserved and survival improved. There was no marked decrease in cardiac levels of triglyceride or the potentially toxic lipids diacylglycerol (DAG) and ceramide. However, long-chain FA coenzyme A (LCCoA) levels were increased, and acylcarnitine content was decreased. Activation of PKCα and PKCδ, apoptosis, ROS levels, and evidence of endoplasmic reticulum stress were also reduced. Thus, partitioning of lipid to storage and oxidation can reverse cardiolipotoxicity despite increased DAG and ceramide levels, suggesting a role for other toxic intermediates such as acylcarnitines in the toxic effects of lipid accumulation in the heart.
    The Journal of clinical investigation 10/2010; 120(10):3443-54. DOI:10.1172/JCI40905 · 13.22 Impact Factor
Show more