Prevalence, patterns and management of diabetic dyslipidemia among black South African patients with type 2 diabetes at a South African semi-urban tertiary Hospital
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Abstract
Background: Despite widespread availability and use of statin lipid lowering drugs in the management of diabetic dyslipidaemia (DD), many patients with Type-2 diabetes mellitus (T2DM) do not reach the lipid targets recommended by most diabetic management guidelines. This study, highlights the prevalence and patterns of DD among black South African patients with T2DM, and assesses the management of DD at Dr George Mukhari Academic Hospital (DGMAH). Methods: Two hundred and three medical records of black South African patients with T2DM were reviewed retrospectively. The last three lipid profile results were recorded and analysed for the presence of DD as well as for the patterns of DD. In addition, information regarding how physicians at DGMAH manage DD was recorded and analysed.Results: The study subjects were predominantly males (58.5%) and the prevalence of DD among the subjects was 56.3%. The patterns of dyslipidaemia observed in the study were mixed dyslipidaemia (7.1%), combined dyslipidaemia (25.7) and single isolated dyslipidaemia (23.5%). The most common types of combined dyslipidaemia were elevated total cholesterol (TC) + elevated low density lipoprotein (LDL) (10.9%) and reduced high density lipoprotein (HDL) + elevated triglycerides (TG) (9.8%) whereas the most common single dyslipidaemia was reduced HDL (15.3%). With regards to the management of DD at DGMAH, the study revealed that physicians at this hospital do not manage DD in accordance with recommendations of most DD treatment guidelines.Conclusion: The prevalence of DD at DGMAH is lower than those previously reported in the literature. The most common patterns of DD at this hospital are the combined (↓[HDL], & ↑[TG] and single isolated reduced HDL. Also, the management of DD at this hospital is not in line with recommendations by treatment guidelines.
Keywords
Diabetic dyslipidaemia, prevalence, patterns, management, South Africans.
Cite this paper
P.T. Moshane, M.A. Mogale, A. Adu, O.A. Towobola,
Prevalence, patterns and management of diabetic dyslipidemia among black South African patients with type 2 diabetes at a South African semi-urban tertiary Hospital
, SCIREA Journal of Clinical Medicine.
Volume 5, Issue 6, December 2020 | PP. 144-159.
References
[ 1 ] | Martín-Timón, I, Sevillano-Collantes C, Segura-Galindo A, and Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength? World J Diabetes. 2014; 5(4): 444–470. |
[ 2 ] | %Kengne AP, Amoah AG, Mbanya JC. Cardiovascular complications of diabetes mellitus in sub-Saharan Africa. Circulation. 2005;112(23):3592-601. |
[ 3 ] | %Brown SH and Abdelhafiz AH. Hyperglycaemia, dyslipidaemia and hypertension in older people with diabetes: the benefits of cardiovascular risk reduction. Therapy 2009; 6(4):515-529. |
[ 4 ] | %Wu L and Parhofer KG. Diabetic dyslipidemia. Metabolism. 2014; 63(12): 1469 -1479. |
[ 5 ] | %Jayarama N, Reddy M, Lakshmaiah V. Prevalence and pattern of dyslipidemia in type 2 diabetes mellitus patients in a rural Tertiary Care Centre, Southern India. Glob J Med Public Health, 2012,1:24–36. |
[ 6 ] | %Pandya, H., Lakhani, J.D. and Trivedi, A. The Prevalence and Pattern of Dyslipidemia among Type 2 Diabetic Patients at Rural Based Hospital in Gujarat, India. Indian Journal of Clinical Practice, 2012; 22(12): 36-44. |
[ 7 ] | %Vezi, ZB and Naidoo, DP. Dyslipidemia among Black patients with Type 2 Diabetes. Cardiovasc. J. S. Afr. 2005; 16: 194-198. |
[ 8 ] | %Daya,R. , Bayat,Z and Raal, F.J. Prevalence and pattern of dyslipidemia in type 2 diabetes mellitus patients at a tertiary care hospital, Journal of Endocrinology, Metabolism and Diabetes of South Africa. 2017; 22:3,31-35. |
[ 9 ] | %Melissa Andrews. Life after apartheid in South Africa. https://gulfnews.com/world/africa/life-after-apartheid-in-south-africa- Accessed 8 January 2018. |
[ 10 ] | %Daniel WW. Biostatistics: A Foundation for Analysis in the Health Sciences. 7th edition. New York: John Wiley & Sons |
[ 11 ] | %CDC, Centers for disease control and prevention, 2016: available at http:/www. CDC.gov/ accessed 10 April 2016 |
[ 12 ] | %Yoshida H. Determination of Fasting and Non-Fasting Cholesterol Levels of Low- and High-Density Lipoproteins with Homogenous Assays: A Promising Reliable Way to Assessment of Dyslipidaemia. J Atheroscler Thromb, 2017; 24: 569-571. |
[ 13 ] | %Martín-Timón, I, Sevillano-Collantes C, Segura-Galindo A, and Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength? World J Diabetes. 2014; 5(4): 444–470. |
[ 14 ] | %Okafor CI, Fasanmade OA and Oke DA. Pattern of dyslipidemia among Nigerians with Type 2 Diabetes mellitus. Nig. J. Clin. Pract. 2008; 11: 25-31. |
[ 15 ] | %Ogbera AO, Fasanmade OA, Chinenye S, and Akinlade A. Characterization of lipid parameters in diabetes mellitus – a Ni gerian report. Int. Arch. Med. 2009; 2: 19. |
[ 16 ] | %Kayode JA, Sola AO, Matew AS, Adesola BA, Ademola I, Adedeji AT and Adelani AS. Lipid profile of type 2 diabetic patients at a rural tertiary hospital in Nigeria. J Diabetes & Endocrinol. 2010; 1(4): 46-51. |
[ 17 ] | %Mithal A, Majhi D, Shunmugavelu M, Talwarkar PG, Vasnawala H and Raza, AS. Prevalence of dyslipidemia in adult Indian diabetic patients: A cross sectional study (SOLID). Indian J Endocrinol Metab. 2014;18(5): 642–647. |
[ 18 ] | %Raal FJ, Blom DJ, Naidoo S, Bramlage P and Brudi P. Prevalence of dyslipidemia in statin-treated patients in South Africa: results of the Dyslipidemia International Study (DYSIS) Cardiovasc J Afr 2013; 24: 330–338. |
[ 19 ] | %Al-Adsani A, Memon A and Suresh A. Pattern and Determinants of Dyslipidemia in Type 2 Diabetes mellitus patients in Kuwait. Acta. Diabetol. 2004; 41: 129-135. |
[ 20 ] | %Klug EQ, Raal FJ, Marais AD. et al., South African Dyslipidemia Guideline Consensus Statement: A joint statement from the South African Heart Association (SA Heart) and the Lipid and Atherosclerosis Society of Southern Africa (LASSA). SMAJ. 2012; 102(3): 178-187. |
[ 21 ] | %SEMDSA. Society for Endocrinology, Metabolism and Diabetes of South Africa. Guidelines for Diagnosis and Management of Type 2 Diabetes Mellitus for Primary Health Care – 2012. JEMDSA. 2012; 14(1): 1-58. |
[ 22 ] | %ADA. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2016; 39 (suppl 1):S1-S106. |
[ 23 ] | %Basak RC, Chatterjee M, and Sarma PSA. An overview on management of diabetic dyslipidemia. J. Diabetes Endocrinol. 2013; 4(3): 27-36. |