Title: An Open-Label, Prospective, Observational Study of Effects of Metformin versus Metformin Plus Glimepiride on Plasma Lipid Profile in Type II Diabetes Mellitus patients in a Tertiary Care Teaching Hospital in Kolkata
Authors: Abhijit Das, Sugoto Datta, Sourav Chakrabarty, Shabnam Ara Begum, Sujit Kr Dey, Apurba Kr Mukherjee
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.144
Abstract
Introduction: Diabetes is considered a global epidemic affecting more than 8% of adult population worldwide. Insulin resistance contributes to the characteristic dyslipidemia associated with Type 2 DM. So by controlling glycemic level, these drugs in combination or alone also may affect plasma lipid parameters. Metformin and Glimepiride are most commonly prescribed anti-diabetic agent.
Methodology: It wasa prospective, parallel group, observational study. In group 1 and group 2 patients received metformin monotherapy and metformin and glimepiride combination therapy, respectively. Doses were adjusted at regular follow-ups by them with an aim to achieve euglycemia. Fasting blood glucose, HBA1C and lipid parameters were assessed at the initiation of therapy and after 3 months.
Results: A total 84 patients completed the study. Group 1 included 44 patients and rest belonged to group 2. However, statistically significant reduction of median triglycerides (TG) & LDL was noted in both groups. There was significant rise in median HDL level within both groups. But after 3 months at follow-up, HDL cholesterol is statistically significantly higher in group 2 compared to group 1. There was no between group difference in respect to median triglyceride and LDL changes. Present study also showed statistically significant median decrease of fasting blood sugar (FBS) and HBA1C from baseline after 3 months of treatment in both groups.
Conclusion: The results of the present study showed that metformin monotherapy as well as metformin and glimepiride combination therapy had beneficial effects on lipid profile in addition to glycemic control. The beneficial effects of these drugs on lipid profile were reassuring in situations where due to various reasons statins cannot be prescribed or cannot be afforded by the patients of type 2 diabetes mellitus.
Keywords: Type II Diabetes, Dyslipidemia, Metformin, Glimepiride, Efficacy.
References
- International Diabetes Federation. IDF Diabetes Atlas, 8th edn.Brussels, Belgium:
International Diabetes Federation, 2017. http://www.diabetesatlas.org accessed on 06th June, 2018. - International Diabetes Federation. IDF Diabetes Atlas, 8th edn.Brussels, Belgium:
International Diabetes Federation, 2017. https://www.idf.org/our-network/regions-members/south-east-asia/members/94-india.html.accessed on 06th June, 2018. - Adiels M, Olofsson SO, Taskinen MR, Boren J. Diabetic dyslipidaemia. CurrOpinLipidol 2006;17:238-46
- DeFronzo RA. Pharmacologic therapy for type 2 diabetes mellitus. Ann Intern Med 2000;133:73-4.
- DeFronzo RA. Pharmacologic therapy for type 2 diabetes mellitus. Ann Intern Med 2000;133:73-4.
- Reasner CA. Reducing cardiovascular complications of type 2 diabetes by targeting multiple risk factors. J CardiovascPharmacol 2008;52:136-44.
- Mughal MA, Jan M, Maheri WM, Memon MY, Ali M. The effect of metformin on glycemic control, serum lipids and lipoproteins in diet alone and sulfonylurea-treated type 2 Diabetic Patients with Sub-Optimal Metabolic Control. J PMA2000;50:381
- Sen S, Sinha S, Gupta KK. Comparative evaluation of effects of combined oral anti-diabetic drugs (sulfonylurea plus pioglitazone and sulfonylurea plus metformin) over lipid parameters in type 2 diabetes patients. Int J Basic Clin Pharmacol 2013;2(3):257-63
- Ingle PV, Talele GS. Comparative effects of metformin in combination with glimepiride and glibenclamide on lipid profile in Indian patients with type 2 diabetes mellitus. Int J Pharm Pharm Sci. 2011;3(5):472-74
- Zhang F, Xiang H, Fan Y, Ganchuluun TA, Kong W, Ouyang Q, Sun J, Cao B, Jiang H, Nie S. The effects of sulfonylureas plus metformin on lipids, blood pressure, and adverse events in type 2 diabetes: a meta-analysis of randomized controlled trials. 2013 Dec;44(3):648-58.