A Comparative Study on the Fasting and Postprandial Dyslipidaemia in Type 2 Diabetes Mellitus

The prevalence of type 2 DM is increasing worldwide, more so in South Asian population due to various factors like, high degree of genetic predisposition and high susceptibility to environmental factor, characterized by a high BMI, high upper body adiposity, a high body fat percentage and a high level of insulin resistance. The dyslipidemia in type 2 DM is different than in non-diabetics, as it has been proposed that composition of lipid particles in diabetic dyslipidemia is more atherogenic than other types of dyslipidemia.

To compare post prandial lipid levels with fasting lipid levels in type 2 diabetes mellitus.

This was a prospective study conducted in a tertiary care hospital in South India from March 2011 to March 2012. The study was approved by the institutional ethics committee. Informed consent was taken from all the included subjects. Blood was drawn from the subjects after 12 hours fasting and 6 hours after meals with staple food for two days. Estimation of lipid profile was done using enzymatic method. The significance of the difference between the groups was assessed by unpaired Student's t-test or Mann Whitney U tests, between cases and controls and P values of <0.05 were considered as statistically significant.

The lipid profile (both fasting and post prandial) was significantly altered in individuals with type 2 diabetes when compared with controls. The postprandial lipid parameters were significantly increased in the type 2 DM subjects as compared to the fasting lipid parameters and the postprandial HDL level was significantly decreased as compared to the fasting HDL level.

It is important to include postprandial lipid profile, in addition to the fasting lipid profile, which helps in better cardiovascular risk assessment in type 2 diabetes mellitus. Appropriate lifestyle changes, such as weight reduction and increased physical activity should be the first step followed by medication with lipid lowering drugs in controlling dyslipidemia in type 2 diabetes mellitus.