Evaluation of the Vasoprotective Effects of Metformin versus Glibenclamide in Type 2 Diabetic Patients

Metformin Monotherapy ◽

Group A ◽

Glucose Lowering Effect ◽

Group B ◽

Oral Hypoglycemic Drugs ◽

Adiponectin (APN) is an adipokine with anti-inflammatory and anti-atherogenic properties decreased in type 2 diabetes mellitus (T2DM) that may influence endothelial function by regulating serum nitric oxide (NO) levels. The current study aimed to investigate the effect of two oral hypoglycemic drugs, Metformin and Glibenclamide (GLC), on circulating APN and NO levels and to find a correlation between APN and NO levels in type 2 diabetic patients. Fifty males and females previously diagnosed with T2DM were conducted in this trial and classified into groups: Group A involved 18 untreated patients with T2DM, group B involved 16 patients receiving Metformin monotherapy (1000 mg/day) for up to 1 year and group C involved 16 patients receiving GLC (5 mg/day) for up to 1 year. Circulating APN and NO were measured. Compared to GLC, Metformin therapy showed a significant increase in APN and NO levels in type 2 diabetic patients. Our findings established that Metformin has a protective effect on endothelial function, including increased APN and NO bioavailability, beyond its glucose-lowering effect.

Non-Diabetic Renal Disease in Type 2 Diabetic Patients with Nephropathy

Journal of Enam Medical College ◽

10.3329/jemc.v10i2.53531 ◽

2021 ◽

Vol 10 (2) ◽

pp. 73-78

Author(s):

Jubaida Khanam Chowdhury ◽

AKM Rashed Ul Hasan ◽

Rajee Mahmud Talukder ◽

Md Nizamuddin Chowdhury ◽

Md Nazrul Islam

Keyword(s):

Diabetic Retinopathy ◽

Diabetic Nephropathy ◽

Renal Disease ◽

Diabetic Patients ◽

Diabetic Renal Disease ◽

Group A ◽

Group B ◽

Background: In diabetic patients a good proportion of nephropathy is due to nephropathy other than diabetic renal disease. The detection of superimposed primary nondiabetic renal disease in diabetic patients has an obvious prognostic and therapeutic importance. Objectives: To find out the proportion of diabetic subjects suffering from nondiabetic renal disease (NDRD) and to describe histological varieties in appropriate group. Materials and Methods: This crosssectional study was done in Department of Nephrology, Dhaka Medical College & Hospital, Dhaka from August 2015 to October 2016. Total 37 type 2 diabetic patients were selected. Renal biopsy was done and four cases were excluded due to inadequate sample. Tissue was sent for histopathology and direct immunofluorescence (DIF) examination. On the basis of histological diagnosis of biopsy reports patients were divided into three groups. Group I: Isolated NDRD, Group II: NDRD superimposed on diabetic nephropathy (mixed lesion) and Group III: Isolated diabetic nephropathy (DN). Each patient was evaluated for retinopathy from Ophthalmology department. Based on the presence or absence of retinopathy 33 patients were again divided into two groups. Group A includes patients with diabetic retinopathy (DR) and Group B includes patients without diabetic retinopathy. Results: NDRD was found in 57.6% cases, NDRD plus diabetic nephropathy (DN) in 21.2% and isolated DN in 21.2% cases. In Group A (patients with DR) NDRD, DN and mixed lesion were present in 7 (41.2%), 5 (29.4%) and 5 (29.4%) cases. In Group B (patients without DR) NDRD, DN and mixed lesion were present in 12 (75%), 2 (12.5%) and 2 (12.5%) cases respectively. p value (0.189) was not significant. Conclusion: Kidney disease other than diabetic nephropathy can occur in type 2 diabetic patients. In this study NDRD was found in high frequency. Lack of retinopathy is a poor predictor of nondiabetic kidney disease. Therefore, renal biopsy should be recommended in type 2 diabetic patients with risk factors of NDRD for accurate diagnosis, prompt initiation of disease-specific treatment and ultimately better renal outcome. J Enam Med Col 2020; 10(2): 73-78

HUBUNGAN KADAR FIBRINOGEN PLASMA DAN MIKROALBUMINURIA PADA PENDERITA DIABETES MELLITUS TIPE 2

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v14i1.918 ◽

2018 ◽

Vol 14 (1) ◽

pp. 11

Author(s):

Rikarni . ◽

Lillah . ◽

Yoesri .

Keyword(s):

Endothelial Dysfunction ◽

Diabetic Patients ◽

Fibrinogen Concentration ◽

Creatinine Ratio ◽

Albumin Creatinine Ratio ◽

Group A ◽

Group B ◽

Increase of fibrinogen concentration in type 2 diabetic patients is an indicator for vascular inflammation, endothelial dysfunction. Hyperfibrinogenemia is a strong marker and independently for atherosclerosis. Beside that, hyperfibrino -genemia can precede macroand microvascular complication. In type 2 diabetic, microalbuminuria is early marker for diabetic nephropathy and show that there isendothelial dysfunction. Microalbuminuria not only useful to predict renal damage, but also useful to predict cardiovascular damage.Microalbuminuria is a marker for endothelial dysfunction. To know the correlation between increase of fibrinogen concentration andmicroalbuminuria in type 2 diabetic patients. The study was performed in Dr. M. Djamil central Hospital by using cross sectionalmethod and consecutive random sampling. Sample were type 2 diabetic patients included criteria were measured albumin/ creatinineratio and the patients was divided in 2 group, that is group A (normoalbuminuria) and group B (microalbuminuria) with totalsample were 90 patients. Each group were performed measurement of albumin/ creatinine ratio, random glucose concentration, andfibrinogen concentration in plasma. In group A, we found the average of albumin/ creatinine ratio is 6.6 μg/mg and in group B is107.5 μg/mg. The average of random glucose concentration in group A is 181.3 mg/dl, and in group B is 204 mg/dl and the difference of concentration is not significantly (p > 0.05). The average of fibrinogen concentration in group A is 383.5 ± 104.6 mg/dl, and in group B is 467 ± 79 mg/dl. Increasing fibrinogen concentration in group B is higher than group A and the increasing is significantlystatistical difference (p <0.05). In this study we also founded the positive correlation between concentration of fibrinogen plasma andalbuminuria ( r = 0.036, p =0.0004). In type 2 diabetic patients with normoalbuminuria has been increased fibrinogen concentration,and the increasing of fibrinogen concentration in type 2 diabetic patients with microalbuminuria is higher than type 2 diabetic patientswith normoalbuminuria. There are positive correlation between fibrinogen plasma concentration and albumin/creatinine ratio

Correlation of Serum Magnesium Level and Blood Glucose status among Type 2 Diabetic Patients

Journal of Current and Advance Medical Research ◽

10.3329/jcamr.v8i2.57431 ◽

2021 ◽

Vol 8 (2) ◽

pp. 106-109

Author(s):

KAM Mahbub Hasan ◽

Asraful Hoque ◽

Naheed Fatema ◽

Mohammed Rashed Anwar ◽

AKM Mohiuddin Bhuiyan ◽

...

Keyword(s):

Blood Sugar ◽

Serum Magnesium ◽

Magnesium Level ◽

Diabetic Patients ◽

Serum Magnesium Level ◽

Group A ◽

Group B ◽

Background: Serum magnesium level is an important electrolytes for the maintenance of haemodynamic of the body. Objective: The purpose of the present study was to correlate the serum magnesium level and blood sugar status. Methodology: This cross sectional study was carried out in the Department of Medicine at Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh from July 2012 to December 2012. All the type 2 diabetic patients admitted in the Department of Medicine in-patient department of ShSMCH who were 18 years and above age with both sexes were included as study population and were designated as group A and non-diabetic patients were included as group B. Blood samples were drawn after an overnight fast for the measurement of fasting blood sugar and serum magnesium. Result: In this present study a total number of 60 patients were enrolled for this study after fulfilling the inclusion and exclusion criteria of which 30 patients were in group A and the rest 30 patients were in group B. The correlation coefficient of FBS and HbA1C with Serum Magnesium level was recorded. The FBS and serum magnesium was negatively correlated to each other significantly which was -0.534. The HbA1C and serum magnesium was negatively correlated to each other significantly which was -0.556. Conclusion: In conclusion the blood sugar level is inversely correlate with the serum magnesium level in type 2 diabetic patients. Journal of Current and Advance Medical Research, July 2021;8(2):106-109

Clinical Observation of Retinal Vessel Density In Type 2 Diabetic Patients With High Mopyopia

10.21203/rs.3.rs-1162983/v1 ◽

2021 ◽

Author(s):

Ruifeng Su ◽

Zhiyang Jia

Keyword(s):

High Myopia ◽

Retinal Vessel ◽

Vessel Density ◽

Diabetic Patients ◽

Group A ◽

Group B ◽

Retinal Vessel Density ◽

Abstract Purpose: To quantitatively analyze the difference of superficial and deep retinal vessel density between diabetic patients with high myopia , diabetic patients without high myopia and normal subjects.Methods: This cross-sectional study recruited type 2 diabetic patients with no history of ocular treatment in Shijiazhuang, China.Thirty type 2 diabetic patients with high myopia (30 eyes) were included in group A, 30 type 2 diabetic patients (30 eyes) without myopia were included in group B. Another 30 sex-,age-matched healthy volunteers (30 eyes)were included in group C. The superficial and deep retinal vessel density were measured and compared among the three groups to determine the effects of high myopia on diabetes.Results: No statistically significant differences in central superficial retinal vessel density(CSVD) was found in three groups（P＞0. 05).There were significant differences in the temporal superficial retinal vessel density（TSVD）,superior superficial retinal vessel density(SSVD), nasal superficial retinal vessel density(NSVD),inferior superficial retinal vessel density(ISVD) between the three groups, respectively (P＜0.05).TSVD,SSVD,NSVD,ISVD in group A were all lower than those in group B and group C(P ＜0.05).ISVD in group B was lower than that in group C and no statistically significant differences in TSVD,SSVD,NSVD were found between groups B and C(P＞0.05). There were significant differences in central deep retinal vessel density(CDVD),temporal deep retinal vessel density(TDVD),superior deep retinal vessel density(SDVD), nasal deep retinal vessel density(NDVD),inferior deep retinal vessel density(IDVD) between the three groups, respectively (P＜0.05).CDVD in group A was higher than that in group B , but there was no significant difference between group A and group C.TDVD,SDVD,NDVD,IDVD in group A were all lower than those in group B and C(P ＜0.05),and those in group B were lower than those in group C(P ＜0.05).Conclusion: Myopia and diabetes are important factors affecting vessel density. The parafoveal superficial and deep vessel density of type 2 diabetic patients with high myopia were lower than those of diabetics and normal persons. However,there was no difference in macular fovea superficial and deep retinal vessel density between diabetic patients with high myopia and normal persons.Myopia did not show a protective effect on retinal vessel density reduction in diabetic patients.

Fenofibrate improves endothelial function in the brachial artery and forearm resistance arterioles of statin-treated Type 2 diabetic patients

Clinical Science ◽

10.1042/cs20090568 ◽

2010 ◽

Vol 118 (10) ◽

pp. 607-615 ◽

Cited By ~ 29

Author(s):

Sandra J. Hamilton ◽

Gerard T. Chew ◽

Timothy M.E. Davis ◽

Gerald F. Watts

Keyword(s):

Endothelial Dysfunction ◽

Endothelial Function ◽

Statin Therapy ◽

Brachial Artery ◽

Ldl Cholesterol ◽

Density Lipoprotein ◽

Diabetic Patients ◽

Dyslipidaemia contributes to endothelial dysfunction and CVD (cardiovascular disease) in Type 2 diabetes mellitus. While statin therapy reduces CVD in these patients, residual risk remains high. Fenofibrate corrects atherogenic dyslipidaemia, but it is unclear whether adding fenofibrate to statin therapy lowers CVD risk. We investigated whether fenofibrate improves endothelial dysfunction in statin-treated Type 2 diabetic patients. In a cross-over study, 15 statin-treated Type 2 diabetic patients, with LDL (low-density lipoprotein)-cholesterol <2.6 mmol/l and endothelial dysfunction [brachial artery FMD (flow-mediated dilatation) <6.0%] were randomized, double-blind, to fenofibrate 145 mg/day or matching placebo for 12 weeks, with 4 weeks washout between treatment periods. Brachial artery FMD and endothelium-independent NMD (nitrate-mediated dilatation) were measured by ultrasonography at the start and end of each treatment period. PIFBF (post-ischaemic forearm blood flow), a measure of microcirculatory endothelial function, and serum lipids, lipoproteins and apo (apolipoprotein) concentrations were also measured. Compared with placebo, fenofibrate increased FMD (mean absolute 2.1±0.6 compared with −0.3±0.6%, P=0.04), but did not alter NMD (P=0.75). Fenofibrate also increased maximal PIFBF {median 3.5 [IQR (interquartile range) 5.8] compared with 0.3 (2.1) ml/100 ml/min, P=0.001} and flow debt repayment [median 1.0 (IQR 3.5) compared with −1.5 (3.0) ml/100 ml, P=0.01]. Fenofibrate lowered serum cholesterol, triacylgycerols (triglycerides), LDL-cholesterol, apoB-100 and apoC-III (P≤0.03), but did not alter HDL (high-density lipoprotein)-cholesterol or apoA-I. Improvement in FMD was inversely associated with on-treatment LDL-cholesterol (r=−0.61, P=0.02) and apoB-100 (r=−0.54, P=0.04) concentrations. Fenofibrate improves endothelial dysfunction in statin-treated Type 2 diabetic patients. This may relate partly to enhanced reduction in LDL-cholesterol and apoB-100 concentrations.

A metformin-monoterápia és a szitagliptin/metformin fix kombináció egyéves perzisztenciája

Orvosi Hetilap ◽

10.1556/650.2016.30423 ◽

2016 ◽

Vol 157 (16) ◽

pp. 618-622

Author(s):

Gábor Simonyi ◽

Tamás Ferenci

Keyword(s):

Fixed Dose Combination ◽

Fixed Dose ◽

Diabetic Patients ◽

Metformin Monotherapy ◽

Dose Combination ◽

One Year ◽

The One ◽

Introduction: In treatment of type 2 diabetes mellitus it is important to reach glycaemic targets. The elements of this are the adequate diet and the patient’s adherence to medication. Aim: The aim of the authors was to investigate the one year persistence of the metformin monotherapy and sitagliptin/metformin fixed dose combination in type 2 diabetic patients. Method: National Health Insurance Found prescriptions database of Hungary on pharmacy-claims between October 1, 2012 and September 30, 2013 was analyzed. The authors identified patients who filled prescriptions for metformin monotherapy and fixed dose combinations of sitagliptin/metformin prescribed for the first time. Patients have not received similar drugs one year previous to study. To model the persistence, the apparatus of survival analysis was used, where “survival” was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied: a generalized linear model was estimated with complementary log-log link function with the kind of drug being the only explanatory variable. Results: During the trial period, metformin monotherapy or sitagliptin/metformin fixed dose combination was started in 63,386 and 10,039 patients, respectively. One year persistence rate in patients with metformin monotherapy was 30%, and 58% in patients with sitagliptin/metformin fixed dose combination. Considering only the 360-day study period, the mean duration of persistence was 173.4 days in patients on metformin monotherapy and 261.9 days on sitagliptin/metformin fixed dose combination. The hazard of discontinuation was more than twofold higher during treatment with metformin monotherapy compared with the use of the sitagliptin/metformin fixed dose combination (hazard ratio = 2.267, p<0.001). Conclusions: There is a significant difference between the one year persistence of metformin monotherapy and sitagliptin/metformin fixed dose combination in type 2 diabetic patients. The result demonstrated sitagliptin/metformin fixed dose combination has a favourable patients’ adherence as compared to metformin monotherapy. Orv. Hetil., 2016, 157(16), 618–622.