scholarly journals A COMPARATIVE STUDY OF EFFICACY AND SAFETY AMONG METFORMIN WITH SITAGLIPTIN, METFORMIN WITH VOGLIBOSE, AND METFORMIN WITH GLIMEPIRIDE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Author(s):  
Kala P ◽  
Jamuna Rani R ◽  
Kumar Js

Objective: Type 2 diabetes mellitus (DM) is a most common metabolic disorder. The present study aimed to compare the efficacy and safety among metformin with sitagliptin, metformin with voglibose, and metformin with glimepiride in patients with type 2 DM. Methods: This study was a prospective, randomized clinical trial study, conducted in patients attending the diabetology outpatient department of SRM Medical College Hospital and Research Center, Potheri, Kancheepuram, Tamil Nadu, from January 2013 to January 2014. The patients were randomized into three groups with 40 patients in each group. Fasting plasma glucose (FPG), 2 hrs postprandial plasma glucose (PPG), and hemoglobin A1c (HbA1c) level were assessed in all the patients before starting the treatment. In Group I, patients were prescribed metformin 500 mg with sitagliptin 50 mg, in Group II, patients were given metformin 500 mg with voglibose 0.2 mg, and in Group III, patients were put on metformin 500 mg with glimepiride 1 mg in the fixed combination. The outcome of the therapy was based on the level of improvement in the blood parameters. Results: There was a significant reduction of FPG level seen in all three groups (p value - Group I <0.0001, Group II < 0.005, and Group III <0.0001). Group I and III showed significant reduction of PPG with p value <0.0001. There was a significant reduction of HbA1c seen in all the three groups (p<0.0001). Conclusion: From the results of this study, it could be concluded that all the three groups were comparable in their efficacy.

Author(s):  
Sindhu Ramarao Ghorpade ◽  
Vijayalakshmi Rajaram ◽  
Jaideep Mahendra ◽  
Burnice Nalinakumari Chelladurai ◽  
Ambalavanan Namasivayam

Introduction: Periodontitis is a polymicrobial and multifactorial oral disease and is the sixth complication of diabetes mellitus. Early diagnosis is important, and the use of non invasive biomarkers are highly useful for this purpose. The level of Macrophage Activating Factor (MAF) and Procalcitonin (ProCT) corresponds to the intensity of the inflammatory response and the severity of infection; thereby indicating that an increase in concentration or persistence of high values is considered as a prognostic indicator for severity of infection with an adverse outcome. Aim: To assess the periodontal parameters and quantify the levels of MAF and ProCT in saliva samples of generalised chronic periodontitis subjects with and without type 2 diabetes mellitus and to correlate these levels with the periodontal parameters. Materials and Methods: The study was a single centre cross- sectional study carried out at the Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India, from November 2018 to November 2019. A total of 80 subjects with generalised severe chronic periodontitis were selected and divided into two groups. Group I comprised of 40 subjects who were diagnosed with generalised chronic periodontitis without type 2 diabetes mellitus, whereas group II comprised of 40 subjects with generalised chronic periodontitis who had already been diagnosed with type 2 diabetes mellitus. Periodontal parameters such as Plaque Index (PI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) were recorded. The collected samples were subjected to molecular analysis for evaluating ProCT and MAF using Enzyme-Linked Immunosorbent assay (ELISA). Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 25.1 (Chicago, USA Inc). Student’s Independent t-test was used to compare the mean values for the variables in the control and test group. The Pearson’s correlation test was used to evaluate correlation between all the variables. The p-value <0.05 was set as the level of significance. Results: On comparing the periodontal parameters between group I and group II, there was no significant difference between the groups p-value >0.05. The mean salivary ProCT level in group I and group II was 268.76±152.78 ng/mL and 785.75±244.37 ng/mL, respectively. The mean salivary MAF level in group I and group II was 7.15±2.02 ng/mL and 26.56±9.12 ng/mL, respectively. On comparing MAF and ProCT value between group I and group II, there was a statistically significant increase in group II (p-value <0.001) and a weak correlation value with the periodontal parameters was seen. Conclusion: There was a significant difference in levels of MAF and ProCT in saliva samples of generalised chronic periodontitis subjects with and without type 2 diabetes mellitus, however the periodontal variables in each group did not correlate with MAF and ProCT.


2017 ◽  
Vol 18 (1) ◽  
pp. 21-26
Author(s):  
Ayesha Jahan ◽  
Rokeya Begum ◽  
Khaled Bin Shamsuddin

Introduction: Osteoporosis and Diabetes Mellitus (DM) are common medical conditions in the society with an increasing prevalence in elderly people. Osteoporosis is more common in female than male and postmenopausal women are vulnerable to it.   Objective: The aim of this study was to verify the effect of type-2 diabetes mellitus on bone mineral density in postmenopausal women and, thereby, to evaluate the risk of osteoporosis in them.   Materials and Methods: This cross-sectional study was carried out at National institute of Nuclear Medicine and Allied Sciences (NINMAS), BSMMU campus, Shahbagh, Dhaka, over a period of one year. 175 postmenopausal women were enrolled as study subjects, among them 72 (41.10%) were diabetic and rest 103 (59.90%) were nondiabetic and they were assigned as Group-I and Group-II respectively. The bone mineral density (BMD) was measured by central DEXA device at lumbar spines and left femoral neck of each study subject.   Results: The mean (±SD) ages of group-I and group-II were 58.79 (±8.06) and 58.27 (±8.39) respectively with an age range of 45 to 75 years in both cases. A total of 30 (41.66%) patients in diabetic group (group-I) and 40 (38.83%) patients in non-diabetic (group-II) had osteoporosis at lumbar spines. On the other hand, 40 (56.94%) patients in group-I and 58 (56.31%) patients in group-II had osteoporosis at femoral neck. The Odds Ratios of osteoporosis for lumbar spines and femoral. neck were 1.125 and 1.026 respectively. The differences of frequencies of osteoporosis between group-I and group-II were not statistically significant at any anatomical site and the association between osteoporosis and type-2 diabetes mellitus was not significant. According to Odds Ratio type-2 diabetes mellitus was not a risk factor for developing osteoporosis in postmenopausal women.   Conclusion: Postmenopausal women are prone to develop osteoporosis and type-2 diabetes mellitus may have adverse influence on osteoporosis, which was supported by few previous studies. This study could not establish any significant effect of type-2 diabetes mellitus on osteoporosis in postmenopausal women.Bangladesh J. Nuclear Med. 18(1): 21-26, January 2015


2021 ◽  
Vol 28 (12) ◽  
pp. 1711-1717
Author(s):  
Nazish Waris ◽  
Samina Bano ◽  
Asher Fawwad ◽  
Abdul Basit

Objective: Association between alanine transaminase (ALT) and aspartate transaminase (AST) with newly diagnosed and known type 2 diabetes mellitus (DM) and to estimate association of liver enzymes with lipid profile in type 2 DM subjects. Study Design: Prospective Clinical study. Setting: Karachi University with Collaboration of Baqai Institute of Diabetology and Endocrinology. Period: November 2018 to May 2019. Material & Methods: Total 100 people were divided into four groups; Group I: 25 healthy controls with normal glucose tolerance, Group II: 25 newly diagnosed DM, Group III: 25 known DM type 2 with <5years duration and Group IV: 25 known DM type 2 between 5-10 years duration. Baseline data was collected on predesigned questionnaire. Blood samples for biochemical parameters were analyzed using standardized laboratory techniques. Results: Group I mean age (years) was 50.78±2.34, group II 50.56±1.96, group III 50.37±1.46 and group IV 56±1.36. In Group I, ALT and AST were significantly correlated to each other’s. In group II, ALT was significantly correlated with AST, triglycerides and HDL-C, while AST correlated with ALT and HDL-C. In group III, ALT was significantly correlated with AST, while AST correlated to ALT, triglycerides and HbA1c. However, in group IV, ALT was significantly correlated with AST, LDL-C and HDL-C, and, AST with ALT, total cholesterol, LDL-C and HDL-C. Conclusion: Elevated ALT and AST- the salient markers for disease of non-alcoholic fatty liver with deranged dyslipidemia were found in known type 2 DM as well as in newly diagnosed type 2 DM subjects.


Author(s):  
PARMAR VINENDRA M ◽  
GOSWAMI SUNITA S

Objective: Teneligliptin is a novel, highly selective dipeptidyl peptidase-4 inhibitor. The objective of the present study was to investigate the efficacy and safety of teneligliptin as add-on therapy in patients with type 2 diabetes mellitus (T2DM) who are inadequately controlled by conventional therapy (metformin/glimepiride) in India. Methods: Clinical study protocol was approved by the Institutional Ethics Committee. T2DM patients (male/female) whose glycated hemoglobin (HbA1c) >7% were randomized to receive following group treatments, namely, Treatment A: Metformin/glimepiride plus add-on teneligliptin 20 mg and Treatment B: Metformin/glimepiride for 24 weeks. A pre-designed case report form was used to collect information from the prescribing physicians regarding the efficacy and safety of teneligliptin. Efficacy variables included change in plasma blood glucose (fasting and postprandial) and HbA1c from baseline to week 24. Treatment emergent adverse events were assessed. Results: A total of 120 type 2 diabetes patients were analyzed. Teneligliptin as add-on therapy with metformin/glimepiride significantly reduced plasma glucose (HbA1c, fasting, and postprandial) concentration as compared to conventional therapy. Conclusion: Add-on therapy with teneligliptin was found superior over conventional therapy in reducing plasma glucose concentration (fasting and postprandial) and HbA1c levels significantly in patients with T2DM. Further, it was found effective and well tolerated in Indian patients with T2DM who are inadequately controlled with conventional therapy.


Author(s):  
P. Kala ◽  
R. Jamuna Rani

Background: The prevalence of coronary artery disease has been increased in diabetic dyslipidemia; hence the present study would like to compare the dyslipidemic effects of Sitagliptin, Voglibose, and Glimepiride in combination with Metformin in type 2 diabetes mellitus patients.Methods: This study was a Prospective, Randomized Clinical trial conducted at SRM medical College Hospital and Research centre. Potheri, Kancheepuram District in diabetic outpatient department after obtaining approval from Institutional Ethics Committee. The patients receiving antidiabetic drugs were divided into three groups. Patients received Metformin with Sitagliptin were grouped as I, Metformin with Voglibose were named as Group II and Metformin with Glimepiride were marked as Group III. Based on the inclusion and exclusion criteria, in each group, 40 patients were assigned as per simple randomization method. The level of lipid profile and BMI was evaluated at the end of 6 months.Results: There was a significant reduction of Total Cholesterol (TC) in Group II and Group III (p value- <0.001, <0.006). Group I showed significant elevation of HDL-C level with the p value of <0.03. Group III showed significant reduction of Triglyceride (TG) level with the p value of <0.04, significant reduction of Low Density Lipoprotein Cholesterol (LDL-C) level with the p value of <0.02 and significant reduction in Very Low Density Lipoprotein Cholesterol (VLDL-C) level with the p value of <0.05. There was no significant reduction in Body Mass Index (BMI) among the groups. On multiple comparisons, Group III showed higher efficacy in reducing TC, TG, LDL-C and VLDL-C levels.Conclusions: The results of this study were analysed and it could be concluded as Metformin with Glimepiride combination (Group III) showed significant reduction of TC, TG, LDL-C and VLDL-C levels.


Author(s):  
Hrishikesh Kashyapa ◽  
Rupali Bajrang Jadhav ◽  
Anuradha Deshkar

Background: Approximately 80% of deaths in diabetic patients are attributable to cardiovascular disease (CVD), which in turn is highly correlated with diabetic dyslipidemia. Statins are drug of choice for raised LDL-C in treating dyslipidemia. The present study compares the efficacy and safety of rosuvastatin against commonly used atorvastatin in patients of type 2 diabetes mellitus with dyslipidemia, so as to guide the present treatment strategies in the management of the same in Indian population.Methods: The study was a single blinded study conducted in a district level tertiary care hospital attached to a medical teaching institute. Patients fulfilling the inclusion criteria were randomized in two groups. Group I received atorvastatin (10mg) and group II received rosuvastatin (5mg) at bedtime orally daily. Serum TC, serum LDL-C, serum HDL-C and serum TG were assessed on week 0, week 6 and week 12.Results: At the end of 12 weeks, the percentage reduction of LDL-C levels in atorvastatin group was 33.58% whereas in rosuvastatin group, it was 43.12%. The percentage reduction in total cholesterol (TC) in atorvastatin group was 24.85% while in rosuvastatin group, it was 30.8%. Rise in HDL-C levels in atorvastatin group was 7.1% whereas in rosuvastatin group, it was 11.16%. All these differences were statistically significant. There was no significant difference in reduction of TG levels between the two groups.Conclusions: Rosuvastatin 5mg causes greater reduction in LDL-C and TC, comparable reduction of TG and greater rise in HDL-C when compared with atorvastatin 10mg therapy.


2014 ◽  
Vol 5 (3) ◽  
pp. 77-81 ◽  
Author(s):  
Kirandeep Kaur ◽  
Rupinder Kaur ◽  
Naveen Mittal ◽  
Shalini Arora ◽  
Sandeep Kaushal

Objectives: To compare the efficacy of add on therapy of Vildagliptin versus Pioglitazone among Type 2 Diabetes Mellitus patients inadequately controlled on dual therapy of metformin and sulfonylureas. Methods: This was an open label prospective non randomized trial conducted on 50 patients attending Endocrinology Outpatient Department in a tertiary care hospital. Patients with type 2 Diabetes Mellitus (Type 2 DM) with age between 30 to 70 years of either gender, on dual oral anti-diabetic treatment (Metformin + Sulfonylurea) for at least last 3 months; HbA1c >7% and < 11%, BMI >25 kg/m2, were included. Group I patients were started on pioglitazone (30 mg once daily) and those in group II started on vildagliptin (50 mg twice daily), in addition to their earlier treatment of metformin and sulfonylurea. Primary end point was change in HbA1c levels after 12 weeks from baseline and secondary outcomes were change from baseline in fasting plasma glucose (FPG) levels and percentage of patients with endpoint HbA1c < 7% at 12 weeks. Results: A significant fall in HbA1c levels was seen in both the groups after 12 weeks of treatment with metformin, sulfonylureas and pioglitazone/ vildagliptin (p<0.001), however the decrease in HbA1c levels at 12 weeks were not statistically different between the two groups (p = 0.16). Only four patients out of a total of 50, showed HbA1c <7% at 12 weeks, out of which three were from pioglitazone and one patient from vildagliptin group. The FPG and random plasma glucose levels also decreased significantly in both the groups (p < 0.001). No adverse effect was reported by the patients. Conclusion: Both vildagliptin and pioglitazone provided additional HbA1c lowering to that achieved with metformin and sulfonylurea. Vildagliptin demonstrates similar efficacy and safety to pioglitazone when added to metformin and sulfonylureas for three months. The clinical study is registered with Clinical Trials Registry of India, no. CTRI/2013/04/003582. Asian Journal of Medical Science, Volume-5(3) 2014: 77-81 http://dx.doi.org/10.3126/ajms.v5i3.9482


Author(s):  
D. Hemalatha ◽  
J. Manjula Devi ◽  
P. R. Kalaiselvi

Diabetes mellitus is a cluster of abnormal metabolic disorder having common features of hyperglycaemia with a state of increased free radical activity. Chronic hyperglycemic status favours auto-oxidation and the formation of advanced glycation end products. Adenosine deaminase (ADA) is considered as a good marker of cell mediated immunity. Increased ADA activity in diabetic individuals could be due to altered insulin related T-lymphocyte function. Hyperglycaemia is associated with increased level of (ADA), which is one of the factor which leads to increase oxidative stress level by generatingthe reactve oxygen species (ROS) leading to insulin resistance. In our study, ADA level was significantly high in controlled diabetes mellitus type 2 (group II with HbA1c < 7) and was much higher in uncontrolled diabetics (group III with HbA1c > 7) compared to healthy controls (group I). The present study was aimed to find the level of Serum (ADA) among the patients with type 2 diabetes mellitus through a case control study and correlation of Adenosine deaminase with glycemic control (HbA1c). Comparison of the parameters fasting plasma glucose (FPG), post prandial plasma glucose (PPPG) HbA1c, and ADA between the 3 groups were done using Student t test and was statistically significant. Pearson’s coefficient correlation was done between ADA and HbA1c and a positive correlaion was seen that was also statistically significant. This indicates that ADA ses with the extent of severity of type 2 diabetes. Positive correlation of ADA with HbA1c provides the information that ADA can be considered to reflect the glycemic status of the individual.


2021 ◽  
Vol 15 (6) ◽  
pp. 2156-2158
Author(s):  
Hina Aslam ◽  
Saima Rafique ◽  
Sidra Mumal ◽  
Furqan Ali Shah ◽  
Abeerah Zainub ◽  
...  

Introduction: Diabetes mellitus type 2 is a global health problem expanding at an alarming rate and putting individuals at high risk of microvascular and macrovascular complications. Life style modification and drugs intervention can help achieve normal glucose levels. Aim &Objective: To compare the hypoglycemic activity of glimepiride and pioglitazone in a type 2 diabetes mellitus induced male mice model. Place & Duration of study: This study was carried out in the animal house of National Institute of Health (NIH), Islamabad from 7th November 2013 till 21st January 2014. Materials & Methods: Forty albino Balb/C male mice were divided randomly into groups I-IV (n=10). Group I served as normal control group. In rest of mice from group II-IV, type 2 diabetes mellitus was induced by administration of high fat diet (HFD) for two weeks followed by low dose (40 mg/kg) intra-peritoneal streptozotocin (STZ) injections for four consecutive days. Group II served as the disease control group. Group III received Glimepiride in a dose of 2mg/kg body wt. while group IV was administered Pioglitazone in a dose of 30mg/kg body wt. Both the drugs were given orally once a day. Samples were taken at the end of ten weeks. Results: The blood samples estimated for fasting blood glucose (FBG) & glycosylated hemoglobin (HbA1c %) levels showed that both glimepiride and pioglitazone equally lowered the FBG and HbA1c% levels. However, pioglitazone lowered the FBG and HbA1c levels slightly more than Glimepride. Conclusion: Glimepiride and pioglitazone lowered the FBG and HbA1c levels in type 2 diabetes induced male mice with the later having slightly more reduction than Glimepride. Key words: Glimepiride, Pioglitazone, Streptozotocin, type 2 Diabetes Mellitus.


2015 ◽  
Vol 09 (03) ◽  
pp. 319-323 ◽  
Author(s):  
Namita Gupta ◽  
Narinder Dev Gupta ◽  
Akash Gupta ◽  
Lata Goyal ◽  
Sagar Garg

ABSTRACT Objective: Although many studies reported more severe periodontal disease and the existing proinflammatory conditions in patients with diabetes but only few have examined the effect of type 2 diabetes mellitus (DM) on salivary matrix metalloproteinase-8 (MMP-8) level and other periodontal parameters. This study aims to evaluate the effect of type 2 DM on salivary MMP-8 levels and periodontal parameters, which might be useful in monitoring periodontal disease in diabetes. Materials and Methods: A total of 90 subjects were selected for the study and were divided into three groups: Group I included 30 healthy subjects; Group II included 30 subjects without type 2 DM but with chronic periodontitis, and Group III included 30 subjects with type 2 DM and chronic periodontitis. Periodontal parameters such as plaque index (PI), gingival index (GI), pocket probing depth (PPD), and clinical attachment level (CAL) were taken. The salivary MMP-8 level was estimated by Quantikine Human total MMP-8 immunoassay kit using ELISA method. Results: The mean value of the salivary MMP-8 of Group III was highest followed by Group II and Group I, the least. The other periodontal parameters PI, GI, PPD, CAL, was comparatively highest for Group III. Conclusion: This study suggests that diabetes is associated with an increased prevalence, extent, and severity of periodontitis. Furthermore, the increased levels of MMP-8 indicate the influence of diabetes on their salivary concentration.


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