Effect of metabolic control of the serum lipid and lipoprotein levels on insulin-dependent diabetes mellitus.

In diabetic patients with poor metabolic control (Group I) and with repeated hypoglycaemic crises (Group II) the serum concentration of cholesterol, triglyceride, of LDL, VLDL and HDL-cholesterol, as well of VLDL and LDL + HDL-triglyceride were measured before and after metabolic control and before and after control of the hypoglycaemic crises. Parallel with the control of diabetic metabolism in Group I, achieved in 15 +/- 6 days, a significant increase in HDL-cholesterol concentration was demonstrable, together with a decrease in the mean value of blood glucose and of daily urinary glucose excretion. In the diabetic patients of Group I, the LDL-cholesterol, serum triglyceride and VLDL-triglyceride levels were significantly higher, the HDL cholesterol levels significantly lower before as well as after metabolic correction, than in the control group. In Group II the serum lipid and lipoprotein lipid concentrations remained unaffected by the control of the hypoglycaemic crises. The results indicate that lipid metabolism in diabetes may considerably be affected by insulin deficiency, but it will respond to an intensified insulin effect. An increase in the concentration of the antiatherogenic HDL-cholesterol is an essential factor of the improvement.