Diabetes mellitus is a major risk factor for cardiovascular disease (CVD), significantly increasing both morbidity and mortality. Glycated hemoglobin (HbA1c) is widely used as a marker of glycemic control to assess CVD risk in diabetic patients. This study aimed to explore the association between lipid profiles, HbA1c levels, and CVD in diabetic patients from Punjab, Pakistan. A retrospective cross-sectional analysis was conducted on 211 diabetic patients with a confirmed diagnosis of CVD. Demographic, anthropometric, and biochemical data were collected for a comprehensive analysis of correlations and regression. The study found that diabetic patients with poor glycemic control (HbA1c >7%) had significantly higher body mass index (BMI), fasting blood glucose (FBG), systolic blood pressure (SBP), cholesterol, and triglyceride levels compared to those with better glycemic control (HbA1c <7%). Poor glycemic control was strongly associated with an increased incidence of ischemic heart disease (33.33%), coronary artery disease (13.82%), and stroke (11.38%). Correlation and regression analysis showed that HbA1c levels were significantly influenced by SBP (p < 0.035), triglycerides (p < 0.025), FBG (p < 0.041), and microvascular complications (p < 0.037). This study emphasizes the importance of regular monitoring of HbA1c and lipid profiles to predict and manage CVD risk in diabetic patients. It also lays the groundwork for designing interventions targeting lipid management to reduce CVD risk, with a recommendation for future longitudinal studies to establish a clearer relationship between glycemic control and CVD outcomes in diabetic patients.

Keywords- Type 2 Diabetes Mellitus, HbA1c, Lipid profile, Cardiovascular diseases, Glycemic control, Risk factors, Cross-sectional study