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Article
The Role of Repaglinide in the Management of Type 2 Diabetes Mellitus

Authors: Abbas M Rahmah --- Majid R Al-Zaidee --- Roaa abbas
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 51-56
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND :Repaglinide belongs to the meglitinide class of blood glucose-lowering drugs.Repaglinide lowers blood glucose by stimulating the release of insulin from the pancreas.It achieves this by closing ATP-dependent potassium channels in the membrane of thebeta cells. This depolarizes the beta cells, opening the cells' calcium channels, and theresulting calcium influx induces insulin secretion.OBJECTIVE:To evaluate the effect of repaglinide as a monotherapy or in combination with metformin oncontrolling the fasting plasma glucose, postprandial plasma glucose, HBA1C, and body weight in61 patients with type 2 diabetes mellitus, (DM).PATEINTS & METHODS:During the period between February 2005 and October 2005, the effects of repaglinidehas been reviewed in 61 patients with uncontrolled Type 2 diabetes mellitus (T2DM),they are divided into two groups depending on their previous treatment , the 1st groupincluded 43 of them were on metformin while the remaining 18 patients were on dietonly. Weight, HBA1c, FPG and PPG were checked after 3 and 6 months.RESULTS:It has been found that six months after using Repaglinide in combination with metformin or as amonotherapy cause significant reduction in HBA1c, from 9.8 to 8.1% (P < 0.01) in 1st group, andfrom 7.9 to 6.7%, (P < 0.01) in 2nd group and a significant reduction of FPG from 214.0 mg/dl to148.5 mg/dl (P < 0.01) in 1st group and from 170.7 mg/dl to 130 mg/dl (P < 0.01) in 2nd group.While the PPG shows a decrement from 255.6 mg/dl to 178.8 mg/dl, (P < 0.01) in 1st group andfrom 248.3 mg/dl to166.1 mg/dl (P < 0.01) in 2nd group. There’s no significant weight gain thusmean weight rose from 84.4 Kg to 84.6 Kg, (P > 0.2) in 1st group and from 75.1 kg to 76.1 kg (P >0.2) in 2nd group .CONCLUSION:Repaglinide when used as monotherapy or in combination with metformin improveoverall glycemic control and significantly reduced HBA1c but have no significantchange in body weight

Keywords

repaglinide --- diabetes --- control.


Article
Study Effect of Glimepiride and Repaglinide on CIMT and Long Glycemic Control in Type 2 Diabetic Patients Double Blind Study

Author: Hussein Aziz Naser
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2013 Volume: 10 Issue: 3 Pages: 683-698
Publisher: Babylon University جامعة بابل

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Abstract

Background Diabetes mellitus (DM) is one of the main risk factors for cardiovascular complications ,namely coronary ischemia, Peripheral vascular disease, and stroke. Atherosclerosis is highly associated with Diabetes mellitus . Carotid intima media thickness (CIMT) is used extensively as a method to detect atherosclerosis.Aim of the study repaglinide and glimepiride are newly introduced and used for non–insulin-dependent diabetes mellitus (NIDDM) ,the study aim to compare the difference in their effect on CIMT. Patients and Methods The study enrolled 62 patients NIDDM all from Al Hakeem Diabetic center in Najaf in period from January 2011 to the March 2012 all had their recording files with mean age (53±0.23), 35females and 27 males with body mass index (BMI) Mean( 28±0.4 ) divided into two groups (blindly grouped) each one 31used Repaglinide 3mg/day and second one used Glimepiride 3mg/day. followed after 6 months and then after 12 months record the hemoglobin A1c(HbA1c), lipid profile , CRP, blood pressure ,the blood urea and serum Creatinine and studying the CIMT of both internal carotid and the common carotid arteries using ultrasonic Doppler study .Results There was a significant( p<0.05) reduction in CIMT of left internal carotid and the right common carotid arteries in patients treated with repaglidine compares to those patients treated with glimepiride and there was also reduction in the other parameters Low-density lipoprotein (LDL) , Triglyceride (TG) ,HbA1c still these decrement were not a significant one.Conclusion and recommendation repaglinide is better in reduction of the CIMT than Glimepiride in spite of insignificant reduction in the lipid profile or HbA1c. We recommend to study what dose required to achieve a best reduction in CIMT.

دراسة مزدوجة غير محددة لتاثيرعقار كلمبرايد وعقار رابكليدين على ثخن الطبقة المبطنة الداخلية للشرايين العنقية في النوع الثاني لمرض السكري مرض السكر يشكل احد اخطر عوامل مضاعفات إمراض جهاز الدوران و الأوعية الدموية وبالأخص عدم كفاءة الشرايين القلبية وإمراض الأوعية الدموية للأطراف والجلطة الدماغية إن تصلب الشرايين يتصاحب مع مرض داء السكر وان قياس ثخن الطبقة المبطنة الداخلية للشرايين العنقية يستخدم بشكل واسع للتعرف على تصلب الشرايين-تهدف الدراسة إلى مقارنة الفرق في التأثير بين العقارين على ثخن الطبقة المبطنة الداخلية للشرايين العنقية-شملت الدراسة62مريضا من النوع غير المعتمد على الأنسولين في مركز الحكيم للسكري في الفترة بين كانون الثاني2011واذار2012وكان عمر المصابين بالمتوسط 53,2 سنة وتوزعوا على 35 من الإناث و27 من الذكور وبمعدل كتلة الجسم 28.4وقد وزع المرضى وبشكل غير محدد على مجموعتين 31استخدموا كلمبرايد 3ملغم و31استخدموا 3ملغم رابكلدين تم إعادة فحص ثخن الطبقة المبطنة الداخلية للشرايين العنقية بواسطة جهاز الأمواج فوق الصوتية بعد 6شهور وبعد 12شهرا مع دراسة مستوى الدهون وحساب معدل السكر التراكمي أثبتت النتائج الإحصائية أن عقار رابكليدين أفضل من عقار كلمبرايد في خفض تخن الطبقة المبطنة الداخلية للشرايين العنقية.

Keywords

diabetes --- glimepiride --- repaglinide --- CIMT

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