[Effect of glucose control on lipid levels in patients with type 2 diabetes].
OBJECTIVE
The dyslipoproteinemia characterizing patients with type 2 diabetes is a major risk factor for atherosclerosis. Prospective studies indicate that an improved glucose control is associated with lower lipid levels. In this study we evaluated whether an improvement of the lipid status can also be observed in a routine clinical setting. Furthermore, we evaluated how many patients achieve lipid target levels by improving glucose control.


METHODS
In 51 type 2 diabetics (60 +/- 12 ys., 29 men, 22 women) lipid values were determined before and after improvement of glucose metabolism (6 - 12 weeks, HbA1c 7.9 +/- 1.9 % vs. 7.1 +/- 1.3 %). Patients on lipid-lowering medication or with atherosclerosis were excluded. The improved glucose control was achieved by starting/intensifying treatment with diet (n = 5), acarbose (n = 5), metformin (n = 10), sulfonylurea/glinide (n = 12) or insulin (n = 19).


RESULTS
The decrease in HbA1c was associated with a decrease in total cholesterol (232 +/- 64 vs. 216 +/- 35 mg/dl, p < 0.05) and triglycerides (348 +/- 448 vs. 216 +/- 139 mg/dl, p < 0.01), while HDL- and LDL-cholesterol did not change significantly. Only in patients with triglycerides > 200 mg/dl did changes in HbA1c-levels correlate with changes in triglyceride-levels (r(2) = 0.32, p = 0.012). Lipid target levels were reached in seven of 51 patients (five of 51 patients before improvement of HbA1c).


CONCLUSIONS
Although in routine clinical practice an improvement in HbA1c results in better lipid values. This improvement is small and is usually not sufficient to reach lipid target levels.
Parhofer
K G
KG
Medizinische Klinik II, Grosshadern, Klinikum der Ludwig-Maximilians Universität München, Germany. parhofter@med2.med.uni-muenchen.de
Laubach
E
E
Geiss
H C
HC
Otto
C
C
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D003927:Diet, Diabetic; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000628:therapy*; D015228:Hypertriglyceridemia / Q000097:blood / Q000628:therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D014280:Triglycerides