Circulating Non-Esterified Free Fatty Acids in Bangladeshi Patients with Type-2 Diabetes: A Cross-Sectional Analysis

Background and Objectives: Free fatty acids (FFA) significantly influence the relationship between obesity, insulin resistance, and type 2 diabetes. Elevated plasma FFA levels, common in obese individuals, inhibit insulin-stimulated glucose uptake in muscle tissue, indicating peripheral insulin resistance. This study examines the levels of non-esterified free fatty acids (NEFAs) in type 2 diabetes patients in Bangladesh to understand their role in the disease and inform management and treatment strategies. Materials and Methods: In this cross-sectional study, 134 participants were involved: 100 had previously been diagnosed with type-2 diabetes and 34 served as a non-diabetic control group. Among the diabetic individuals, 60% were newly diagnosed with type-2 diabetes mellitus, 28% had been previously treated but had uncontrolled diabetes, and 11% had been treated and had controlled diabetes and 0.75% had gestational diabetes. The sample included 42.5% males and 57.5% females. Sociodemographic and health data, including BMI, hypertension, cardiovascular history, and lifestyle habits, were collected through questionnaires. Blood pressure was measured per ACC/AHA guidelines. Blood samples were analyzed for glucose, NEFA, and lipid profiles using automated analyzers. NEFA estimation followed specific reagent procedures, while lipid profiling assessed total cholesterol, HDL, LDL, and triglycerides per ADA guidelines. Data were analyzed using Excel and SPSS, with significance set at p<0.05. Results: NEFA levels were significantly higher in diabetic patients (647 µM/L) compared to healthy controls (331.5 µM/L). Significant associations were found between NEFA levels, insulin resistance, and diabetes. Controlled diabetics had lower NEFA levels than uncontrolled ones. Lifestyle factors like work hours and exercise habits correlated with NEFA levels, highlighting their importance in diabetes management. Conclusion: Elevated NEFA levels are common among diabetic patients in Bangladesh, influenced by disease control status and lifestyle factors. Effective diabetes management requires comprehensive strategies targeting NEFA levels through medical and lifestyle interventions Key words: Non-esterified free fatty acids (NEFAs), type 2 diabetes, insulin resistance, atherosclerosis and cardiovascular disease.