Effects of metformin+sitagliptin versus metformin + glibenclamide combinations on lipid profile, body mass index and kidney function in Iraqi patients with type 2 diabetes mellitus.

Abstract

Abstract:Until 1995, only two options for pharmacologic treatment were available for patientswith diabetes; sulfonylurea (for type 2 DM only) and insulin (for type 1 or 2). Since 1995, anumber of new oral agents, injectables, and insulins have been introduced in therapy.Currently, six classes of oral agents are approved for the treatment of type 2 diabetes: ,sulfonylurea, α-glucosidase inhibitors, biguanides, meglitinides, thiazolidinediones orglitazones& dipeptidyl peptidase-4 inhibitors.This study aimed to evaluate the lipid profile, kidney function and BMI by using twocombinations of drugs metformin + glibenclamide and metformin + sitagliptin on patientswith T2DM.Sixty eight T2DM patients (and categorized in to two treatment groups) and 34normal healthy individuals as control group were enrolled in this study group 1 (34 patients )received metformin 500 mg three times daily + glibenclamide 5 mg twice daily and group 2(34 patients) received metformin 500 mg three times daily + sitagliptin 100 mg once daily.From each patients 10 ml of blood was obtained by veinpuncture and the serum was separatedand used for estimating the lipid profile, kidney function (blood urea and serum creatinin).The mean calculated serum total cholesterol(TC), serum triglyceride(TG), low densitylipoprotein cholesterol (LDLc)and very low density lipoprotein cholesterol(VLDLc) weresignificantly(p<0.05) lower for group 2 patients after 3 & 6 months of treatment (225.88 ±6.62 mg/dl,214.32 mg/dl ± 4.86 and 197.61 mg/ dl ± 3.4), (252.08±9.07mg/dl, 234.02 mg/dl ±6.44 and 196.0 mg/dl ± 5.70 ), (96.2± 2.03mg/dl, 94.26 mg/dl ± 2.58, 88.17 mg/dl ± 1.79) and(78.38±3.65mg/dl, 68.50 mg/dl ± 2.9, 60.52 mg/dl ± 2.26)respectively as compared to group1 (245.7 ± 2.87,235.61mg/dl ± 2.64, 224.9 mg/dl ±2.98 ), (257.38 ± 9.25,249.67 mg/dl ± 8.19, 235.7 mg/dl ± 7.83 ), (103.14 ± 2.19, 95.64 mg/dl ± 1.19 , 91.64 mg/dl ± 1.196) and (94.74mg/dl ± 2.93 , 83.79 mg/dl ± 3.28 ) respectively. The picture was different for high densitylipoprotein (HDLc) where, significantly (p<0.05) increased for group 2 patients after 3&6months of treatment (48.37± 1.07, 49.9 mg/dl ± 1.16 and 51.14 mg/dl ± 1.35 ) compared togroup 1 patients (43.02±1.24, 44.67 mg/dl ± 1.28 , 46.52 mg /dl ± 1.22). The mean calculatedbody mass index (BMI) was significantly (p<0.05) lower for group 2 patients after 1&6months of treatment (26.7 ± 0.35 and 25.3 ± 0.35) than in group 1 patients (28.5 ± 0.55 and26.95 ± 0.43.This study also showed significantly(p<0.05) lower mean serum blood urea and serumcreatinine level for group 2 patients after 3&6 months of treatment (42.9 ± 1.30 , 44.0 ± 1.48and 44.0 ± 1.59 mg /dl ),( 0.89 ± 0.03 , 0.91 ± 0.03 and 0.98 ± 0.05 mg/dl) respectivelycompared to that of group 1(60.0 ± 4.25 , 63.0 ± 4.4 and 64.0 ± 4.34 mg/dl), (1.23 ± 0.54 ,1.26 ± 0.55 and 1.32 ± 0.54 mg/dl) respectively.IN conclusion, the combination of metformin + sitagliptin improved lipid profile,kidney function and body mass index more than metformin +glibenclamide combination.