Dietetic Analysis and Blood Lipids, Chemical and Isotopic Studies in Vascular Disease Among Indian Diabetics

Abstract

Among patients attending a hospital in Delhi area (North India) 200 subjects were selected for study of diet, its relation to serum lipid fractions, and variation due to diabetes. A study of dietetic habits by questionnaire method revealed the amount of total average calories to be 2,000/day, carbohydrates 60%, fat (animal, vegetable) 28.6%, and protein (animal and vegetable) 11.4%. A significant degree of hyperlipemia was observed in all the groups of patients; diabetics and those with vascular disease when compared to the normal individuals. Diabetics with vascular disease had significantly high total serum lipid values as compared to those having diabetes mellitus, or vascular disease alone. Cholesterol and phospholipids were not different in patients with vascular disease with or without diabetes. Triglyceride levels were maximum in the group of patients having diabetes mellitus and vascular disease, when compared to the group having diabetes mellitus or vascular disease alone. This lipid fraction was significantly elevated in nondiabetics having vascular disease, when compared to diabetics having no vascular disease, i.e., triglycerides were consistently high in patients having vascular disease, and this abnormality increased in diabetics with vascular disease. Isotopic studies collaborated the altered neutral fat tolerance in both the groups of diabetics; the diabetics with vascular disease showed an increased rise of neutral fat and sustained it for a longer duration as compared to those who did not have vascular disease. Patients with vascular disease, but no diabetes, showed similar abnormalities but to a lesser degree. It is therefore concluded that, at least in metabolic disorders like diabetes, the dietary fat did not seem significantly contributory to the serum lipid levels. With the presence of vascular disease among diabetics, the increase of triglyceride and delay in its turnover were significant and exceeded those seen in those with vascular disease alone. High carbohydrate intake in the local diets through intermediary metabolism or an anomaly of endogenous fat turnover may account for the lipid pattern observed among the diabetics in this part of the world.