Lipid Control Rate, Pattern and its Associated Factors Among Patients with Type 2 Diabetes Mellitus in Muscat: A Cross-Sectional Study/2022

Noncommunicable diseases (NCDs) account for 74% of all deaths worldwide, killing 41 million people each year. Diabetes kills 2.0 million a year. NCDs share four major risk factors: tobacco use, physical inactivity, the harmful use of alcohol, and unhealthy diets.(1)

Unbalanced levels of lipids, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and total cholesterol, are known as dyslipidemia. This condition can result from diet, tobacco exposure, or genetics and can lead to cardiovascular disease with severe complications.(2)

Dyslipidemia is an important risk factor for coronary artery disease and stroke. Patients with type 2 diabetes have an increased risk of cardiovascular disease and mortality due to the common co-occurrence of dyslipidemia(3)

Lipid control is very important in the management of diabetes. There is limited real-world data on lipid control in diabetic patients in Oman. The study aimed to determine the lipid profile's control rate, examine the effect of good glycemic control on the lipid profile, and assess other associated factors in T2DM patients in Muscat, Sultanate of Oman.

We conducted across sectional study in the Muscat region, the target group was type 2 DM patients aged 20 years and above, from 1 January to 31 December 2022. Sampling was a multistage sampling technique. Data was collected from the primary health care center from the record system, (alshifa system). The variables are demographics, clinical features, complications, and laboratory findings were collected.

A total of 378 T2DM patients were enrolled in this research. 241 patients (64%) had controlled HDL-Cholesterol, 195 (52.0%) had controlled LDL-Cholesterol, and 278 (73%) had controlled Triglyceride. The analysis showed older age was associated with good lipid control for LDL and TG. In addition, the male gender was associated with a better LDL control rate while the female gender was associated with a better HDL control rate.

Also, following a meal plan showed an association with the control rate of TG while not smoking was associated with HDL control rate 0.02). Moreover, having good glycemic control (HbA1c<7) was associated with a better control rate of all lipid profiles LDL, HDL, and TG. There was also an association between not having CVD and the control rate of LDL.

In summary,  this study, which included a wider range of Omani patients, showed better control compared to previous study in Oman. This difference might be due to a setting where patients following up in the hospital are expected to have poorer outcomes.

Better lipid control rates were associated with a healthier lifestyle, not having CVD, and most importantly diabetic control.

Therefore, health planners in this field should concentrate on modifiable risk factors and encourage behavioral counseling as a means of promoting healthy lifestyles. Implementing an early strategy to return blood cholesterol levels to baseline may reduce cardiovascular disease. The best course of treatment for this illness should involve routinely checking lipid profiles and blood glucose levels

References:

1.          Noncommunicable diseases [Internet]. [cited 2023 Jun 25]. Available from: https://www.who.int/health-topics/noncommunicable-diseases#tab=tab_1

2.          Pappan N, Rehman A. Dyslipidemia. Chronic Disease Follow-Ups for Adults in Primary Care [Internet]. 2022 Jul 11 [cited 2023 Jun 25];243–56. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560891/

3.          Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of Type 2 Diabetes Mellitus. Int J Mol Sci [Internet]. 2020 Sep 1 [cited 2024 May 16];21(17):1–34. Available from: /pmc/articles/PMC7503727/

Table 3: Bivariate Analysis for Factors Associated with Lipid Control Rate Among Participants (n=378)

_{HbA1c: Glycated Hemoglobin; BMI: Body Mass Index; CI: Confidence Interval; DM: Diabetes Mellitus; OR: Odds Ratio}