Glycemic
Optimization Improves Diabetic Dyslipidemia
A drop in A1c has a corresponding rise in HDL.
Glycemic
optimization should be used as a therapeutic tool
for improving diabetic dyslipidemia. That from
a presentation at last weeks AACE.
The
researchers set about to quantify the predictive
value of reducing hemoglobin A1c (HbA1c) levels
on lipid and lipoprotein concentrations in patients
with type 2 diabetes.
"These
patients are at higher risk of developing cardiovascular
disease, particularly coronary disease,"
explained Alberto de Leiva, MD, PhD, chief of
the department of endocrinology, Hospital de Sant
Pau, and professor of medicine, Universitat Autònoma
de Barcelona, Barcelona, Spain.
The
study group consisted of 73 patients with type
2 diabetes, 44% of them women. Mean age was 60.9
years. Measurements of total triglycerides and
cholesterol, low-density lipoprotein (LDL), high-density
lipoprotein (HDL), apolipoprotein 1 (apo 1), and
apolipoprotein B (apo B) were taken at baseline
and follow-up.
After
a median follow-up of 3 months, the mean HbA1c
decreased to 6.7% (range: 3.8 to 8.0%) from a
baseline level of 9.9% (range, 6.2 to 16.0%).
The
study found that, after correcting for potential
confounding variables such as body mass index,
age, and gender, for each percentage-point reduction
in HbA1c, there was an increase in HDL cholesterol
and its carrier protein apo A-1 (0.007 mmol/L
and 0.087 g/L, respectively).
HDL
(r=-03.58, P=0.01) and apo A-1 (r=-0.355, P=0.003)
were the only lipid factors that correlated significantly
with the decrease in HbA1c level. "Quantitative
estimation of those variables allows a prediction
of the potential benefit of improving glycemic
control on lipids," Dr. de Leiva noted.
"Our
study supports previous work showing a favorable
effect of improving glycemic control on lipid
and lipoprotein concentrations both in type 1
and type 2 diabetic patients," Dr. de Leiva
concluded.
[Study
title: Quantitative Effect of Improving Glycemic
Control on Lipids and Lipoproteins in Type 2 Diabetes
Mellitus: Is it Predictable? Abstract 68]
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