Plasma lipid profiles and vascular disease in type 2 (non-insulin dependent) Nigerian diabetic patients

Although ischaemic vascular disease is uncommon in Nigerians (diabetic and nondiabetic), foot gangrene of vascular origin still causes considerable morbidity in Nigerian diabetics. One known cause of vascular disease is lipid abnormalities. We therefore measured plasma lipid levels in diabetic patients with foot gangrene of vascular origin and compared those results with values in diabetics without gangrene and nondiabetic subjects, in relation to other variables such as glycaemic control, disease duration and body mass index. 45 noninsulin dependent diabetics (10 with foot gangrene) and 22 nondiabetic control subjects were studied. Those diabetics with gangrene had poorer (p less than 0.001) short-term glycaemic control (as assessed from fasting blood glucose levels) than those without, although longer-term control (HBA1C) was similar in both groups. Plasma triglyceride levels were significantly elevated in diabetics with or without gangrene (p less than 0.001) compared to nondiabetic subjects, while total cholesterol levels were high only in those with gangrene (p less than 0.02) who also had a longer disease duration. Plasma phospholipid and HDL-cholesterol did not differ significantly from control values. We therefore conclude that the raised plasma cholesterol and longer duration of diabetes in those diabetics with foot gangrene may have contributed to the genesis of vascular disease in those subjects.