Journal of Metabolic Syndrome

A Study of Glycemic, Insulinemic and Lipidemic Abnormalities in Controlled vs. Uncontrolled T2dm with Particular Reference to Hba1c% Level

Abstract

Amrita Bhowmik, Mossihuzzaman Mohammed, Begum Rokeya* and Yearul Kabir

Objective: The global incidence of diabetes is escalating at an alarming rate. This study aims to compare glycemic control, insulin resistance, lipid profiles, and serum creatinine levels in individuals with controlled and uncontrolled diabetes and assess clinical parameters based on the duration of uncontrolled diabetes.

Methods: A cross-sectional study was conducted on 357 individuals with T2DM aged 40–60 years. Participants were divided into two groups based on HbA1c% levels: controlled diabetes (HbA1c ≤ 7.0%, n=143) and uncontrolled diabetes (HbA1c>7.0%, n=214). Further subdivision categorized subjects by disease duration: short-term (<5 years) and long-term (>5 years). Fasting Blood Glucose (FBG), insulin, HbA1c%, triglycerides, total cholesterol, HDL-C, LDL-C, and creatinine levels were measured using standardized techniques. Indices such as HOMA B%, HOMA S%, HOMA IR, QUICKI, and Sr HOMA were calculated using appropriate methods. Statistical analyses were performed using independent t-tests and Fisher's exact test, with significance set at p < 0.05.

Results: BMI (p=0.05), FBG (p<0.001), HOMA IR (p<0.05), TG (p<0.005), T Chol (p<0.05), and LDL (p<0.001) level were significantly higher in uncontrolled DM in compared to controlled DM subjects, respectively. Whereas, Sr HOMA (p<0.05) was significantly lower in uncontrolled DM than in the control DM group. A high degree of positive correlation of HbA1C% with FBG (r=0.298, p<0.001) and GIR (r=0.166, p<0.05) was found, as well as a significant (r= -0.164, p<0.05) negative correlation was found with HOMA B% in uncontrolled DM subjects respectively. However, HOMA B% and Sr HOMA significantly (p<0.05, both) decreased, and HOMA S% significantly (p<0.05) increased in uncontrolled DM subjects who had a longer duration of DM. Serum creatinine level was significantly higher in uncontrolled DM compared to the controlled DM subjects.

Conclusion: FBG, insulin resistance, and lipid parameters were elevated in uncontrolled diabetic subjects, which may lead to the impairment of renal function.