Effects of therapy on plasma-high-density-lipoprotein-cholesterol concentration in diabetes mellitus.

In 122 diabetic patients there was a signnificant inverse correlation between plasma-high-density-lipoprotein (H.D.L.)-Cholesterol concentrations and glycosylated haemoglobin concentrations. In an insulin-treated subgroup improvement in diabetic control, confirmed by a decrease in glycosylated haemoglobin concentrations, was accompanied by a significant rise in plasma-H.D.L.-cholesterol concentration. This result suggests that improved diabetic control may diminish the risk of premature ischaemic heart-disease. When three groups of patients on different treatments were matched for age, sex, weight, and diabetic control, diabetic patients receiving sulphonylureas had significantly lower plasma-H.D.L.-cholesterol concentrations than those receiving insulin or on diet alone, or non-diabetic controls. This association suggests that sulphonyl-urea administration may constitute a positive risk factor for ischaemic heart-disease in diabetic patients.