Abstract:

Background: Diabetes mellitus often causes dyslipidemia, which increases the risk of arteriosclerotic vascular disease. Different countries have established various guidelines for the management of dyslipidemia. Despite significant advances in dyslipidemia treatments, the prevalence of dyslipidemia remains high in various parts of Tanzania and around the world. Little is known about the prevalence of dyslipidemia and the risk factors associated with it among patients with diabetes mellitus attending at Bugando Medical Centre (BMC), Mwanza, Tanzania.

Objective: The objective was to determine the prevalence, patterns and associated factors of dyslipidemia among patients with diabetes mellitus attending Bugando Medical Centre, Mwanza, Tanzania.

Methodology: This was hospital-based cross-sectional study that took place at Bugando Medical Centre's outpatient department from February to April 2024. A systematic sampling was used to enrol total of 220 diabetes mellitus patients aged above 18 years. Structured questionnaires were used to collect demographic and clinical information. Blood samples were collected in order to assess the HbA1C and lipid profiles. Dyslipidemia was defined by NCEPATP III, as at least one abnormality in lipid parameter among the following; TC > 5.2 mmol/l or TG > 1.7 mmol/l or HDL-C < 0.9 mmol/l or LDL-C > 2.6 mmol/l. Data was cleaned, entered and analysed by STATA 17.

Results: The prevalence of dyslipidemia was 76.8% (169/220) and only 33.2% were on lipid lowering therapy. The most common pattern was single dyslipidemia which was high LDL-C at 60.9% (134/220) and the most common mixed dyslipidemia was TC+HDL-C+LDL-C at 47% (79/168) among all patients with dyslipidemia. Factors associated with dyslipidemia were educational status (APR 0.72 95%CI=(0.59-0.87);P=0.001) for primary education, (APR0.72 95%CI=(0.55-0.94); P=0.008) for secondary education and above, marital status (APR 1.63 95%CI=(1.25-2.13); P< 0.001) for those single, (APR 1.30 95%CI=(1.05-1.61); P=0.013) for those divorced, for every unit increase in BMI (APR 1.0001 95%CI=(1.-1.0002); P< 0.003), for participants who were on lipid lowering agent (APR =0.76, 95% CI= (0.63-0.92); P-value= 0.005) and glycated hemoglobin (APR =1.04, 95% CI= (1.00-1.07); P-value=0.032).

Conclusion: The prevalence of dyslipidemia is high among patients with diabetes mellitus attending Bugando Medical Centre, Mwanza.The commonest type of lipid derangement was high LDL-C 60.9%. BMI, poor glycaemic control, having primary school or secondary school education and being single or divorced were important risk factors for dyslipidemia. In the light of such high burden of dyslipidemia in this population, we recommend yearly screening of lipid profiles for patient with diabetes mellitus and start moderate intensity statins to patients with diabetes mellitus aged 40 years and above.