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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
Relationship between microalbuminuria and glycosylated hemoglobin, and some biomarkers of oxidative stress in type 2 diabetes mellitus

Authors: Hawazin Yousuf Khalaf --- Abdulkareem H. Issa --- Abbas M. Rahmah
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2015 Volume: 28 Issue: 2 Pages: 85-93
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Diabetic nephropathy is a common chronic complication in type 2 diabetes mellitus (T2DM) at the time of diagnosis or later on and to progress with longer duration of the disease. Microalbuminuria (MIC) heralds diabetic nephropathy and precedes proteinuria and is an important risk factor for cardiovascular disease (CVD).Once proteinuria develops after microalbuminuria, progression to end-stage kidney disease occurs rapidly over ~5 years.Objective: To identify the relative importance of glycemic control status and some oxidative stress markers in the discrimination between patients with and without MIC so that the more important ones may be a priority targets in the prevention or treatment of diabetic nephropathy.Subjects and methods: One hundred female T2DM patients and 50 apparently healthy aged-matched women as a control group were enrolled in the study. Diabetic patients comprised two groups; group A: DM patients without MIC; group B: DM with MIC. For each study subject, clinical characteristics were recorded and the following parameters were measured: Urinary Albumin: Creatinine ratio (A:C ratio), and serum levels of fasting glucose , HbA1C, uric acid, thiobarbituric acid-reactive substances (TBARS), and α-tocopherol.Results: Group B patients were found to have a significantly higher mean value of BMI, blood pressure, and longer duration of disease. The mean ratio of HbA1C of group B was significantly higher than in group A (8.7 ± 1.4% vs. 7.1 ± 1%, P < 0.001). On comparison of oxidative stress markers then group B had higher serum TBARS (8±1 vs. 5.9±1 µmol/L, P<0.001), and uric acid (5.8±1vs. 4.9±1.1 mg/dl, P<0.001) than in group A but the two groups showed no significant difference in α-tocopherol. The results revealed that there is a high significant positive correlation between serum TBARS levels and uric acid levels in group B (r = 0.565, p <0.001), while it showed a statistically significant negative correlation between TBARS levels and α-tocopherol levels (r = - 0.837, p<0.001).Receiver operator characteristic (ROC) curve was used to discriminate between group B and A. The area under the curve was highest for serum TBARS (ROC area =0.909) followed by HbA1C (0.814) and their diagnostic accuracy were 85% and 77% respectively.Conclusion: Poor glycemic control and oxidative stress are interrelated states that characterize T2DM patients. Among study analytes, serum levels of TBARS and HbA1c have the highest relative importance in discrimination between patients with and without MIC so that may be, in sequence, a priority targets in the prevention and treatment of diabetic nephropathy.

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