-
The Effect Of Antidiabetic Agent Glibenclamide And Meltformine On Lipids And Glycated Haemoglobin In Type 2 Diabetes Patient Attending Uith Ilorin
CHAPTER ONE -- [Total Page(s) 2]
Page 1 of 2
-
-
-
CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND OF STUDY
Diabetes mellitus (DM) has been defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both (Akinmokun et al., 1992). Insulin is a hormone produced in pancreas and enables body cells to absorb glucose that is converted into energy when the body is in need. If the body cell does not absorb the glucose, it will accumulate in the blood causing "hyperglycemiaâ€, chronic hyperglycemia however leads to various potential complication (Pasquali, 2000).
Under normal physiological conditions, plasma glucose concentrations are maintained within a narrow range, despite wide fluctuations in supply and demand, through a tightly regulated and dynamic interaction between tissue sensitivity to insulin (especially in liver) and insulin secretion (DeFronzo and Goodman, 1995). In type 2 diabetes these mechanisms break down, with the consequence that the two main pathological defects in type 2 diabetes are impaired insulin secretion through a dysfunction of the pancreatic β-cell, and impaired insulin action through insulin resistance (Holt, 2004). Type 2 Diabetes mellitus has a greater genetic association than type 1 DM, the pathogenesis of type 2 Diabetes mellitus is characterized by impaired insulin secretion and insulin resistance. Some causes of insulin resistance are:
1. Obesity/overweight (especially excess visceral adiposity)
2. Excess glucorticoids (cushing’s syndrome or steroid therapy)
3. Excess growth hormone (acromegaly)
4. Pregnancy, gestational diabetes
5. Polycystic ovary disease
6. Lipodystrophy (acquired or genetic, associated with lipid accumulation in liver)
7. Autoantibodies to the insulin receptor
8. Mutations of insulin receptor
9. Mutations of the peroxisome proliferators’ activator receptor γ (PPAR γ)
10. Mutations that cause genetic obesity (e.g., melanocortin receptor mutations)
11. Hemochromatosis (a hereditary disease that causes tissue iron accumulation) (Guyton and Hall, 2006).
The metabolic syndrome (MS), or insulin resistance syndrome accommodates the clustering together of certain cardiovascular risk factors associated with insulin resistance and hyperinsulinemia (Campbell, 2005). It was first identified in 1988 by Gerald Reaven, a Stanford University endocrinologist, in a lecture to the American Diabetes Association. At various times, this syndrome has been called dysmetabolic syndrome, insulin resistance syndrome or syndrome X. Now simply known as metabolic syndrome (Reaven et al., 2005). Metabolic syndrome is associated with a high risk of coronary heart disease and premature mortality (Isomaa et al., 2001). Besides resulting in macrovascular complications, there is growing evidence that metabolic syndrome, like Diabetes mellitus, causes micro vascular complications in patients with type 2 Diabetes mellitus (Knowler et al., 1990). Nearly 70-80% of the population with Diabetes mellitus is diagnosed with metabolic syndrome. Metformin is a biguanide euglycemic agent, has been approved by the food and drug administration for the treatment of type 2 Diabetes mellitus (Drouin et al., 2004). Although metformin is as effective as sulfonylureas, the drug differs in several respects: Metformin reduces insulin resistance without directly affecting insulin secretion, causes weight loss rather than weight gain, and has lactic acidosis rather than hypoglycemia as its most serious side effect (Kaku, 2010). Glibenclamide is a second-generation sulfonylurea drug. It is at least as effective as the first-generation agents and is effective in doses that are considerably less than those needed with first generation sulfonylureas (Charles ,2010). It is a useful medication for patients with type 2 diabetes whose hyperglycemia is not adequately reduced by dietary management and exercise. It can be used as the initial drug in these patients or as the replacement drug for those with primary or secondary failure during therapy with first generation sulfonylureas (Charles, 2010). Side effects are minimal, and the most important is hypoglycemia. Although no difference persists between the treatment groups for total-cholesterol, triglycerides, HDL-cholesterol, and LDL-cholesterol, the antidiabetic agents seem to lower serum lipids most effectively, which may help prevent coronary events in T2DM patient (Penbe et al., 2003).
CHAPTER ONE -- [Total Page(s) 2]
Page 1 of 2
-
-
ABSRACT - [ Total Page(s): 1 ]Abstract Is Coming Soon ... Continue reading---
APPENDIX A - [ Total Page(s): 1 ]APPENDIX IQUESTIONAIRE TO ACCESS THE ANTHROPOLOGIC INDICES OF PATIENTS WITH TYPE TWO DIABETES MELLITUS ON ANTIDIABETIC DRUGS (METFORMIN AND GLIBENCLAMIDE) ATTENDING UITH ILORIN.INTRODUCTION: I am a final year students of the Department of Medical Laboratory Science, School of Basic Medical Sciences, Kwara State University, Malete, Kwara State. This questionnaire is aimed at accessing the demographic indices of patients with type 2 Diabetes mellitus on metformin and diabinese in Ilorin metropolis ... Continue reading---
APPENDIX B - [ Total Page(s): 5 ]Step 2100µl of the supernatant was dispensed into the clean test tubes respectively.2ml of the cholesterol reagent was addedIt was incubated at room temperature for 10minsAbsorbance of sample against reagent blank was measured at 505nmGlycated HaemoglobinGlycated Haemoglobin is a form of haemoglobin that is measured primarily to identify the three-month average plasma glucose concentration. The test is limited to a three-month average.ProcedureReagentsBlank(µl) samp ... Continue reading---
CHAPTER TWO - [ Total Page(s): 11 ]Triglycerides as major components of very low-density lipoprotein (VLDL) and chylomicrons, play an important role in metabolism as energy sources and transporters of dietary fat. They contain more than twice as much energy (approximately 9kcal/g or 38kj/g) as carbohydrates (approximately 4kcal/g or 17kj/g) (Brefere et al., 2014).2.5 Glycated hemoglobin (hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also referred to as being Hb1c or HGBA1C) is a form of hemoglobin that is measured primarily to i ... Continue reading---
CHAPTER THREE - [ Total Page(s): 1 ]CHAPTER THREE3.1 Material and Method3.2 Study AreaThe study was carried out at University of Ilorin Teaching Hospital, Ilorin, Kwara State. The hospital is located at the State capital of Ilorin, Kwara State Nigeria. It is a referral center to other public and private hospitals within and outside the state.3.3 SAMPLE SIZE DETERMINATIONThere was a random selection of ninety (90) subjects, 60 were type 2 Diabetes mellitus individual using either one or combine antidiabetic agent (glibe ... Continue reading---
CHAPTER FOUR - [ Total Page(s): 4 ]Tables 4.6: Correlation of Duration in Diabetes and BMI with biochemical parameters (T. cholesterol, High Density Lipoprotein, Low Density Lipoprotein, triglycerides, glycated, and fasting blood sugar) in Diabetic patient using antidiabetic drugs (Metformin and Glianpride). ... Continue reading---
CHAPTER FIVE - [ Total Page(s): 2 ]CHAPTER FIVE5.0 DISCUSSIONThe study shows discrepant results about the influence of metformin on lipid profile (10). Some studies, in agreement with ours, reported reduction only in TC levels (Grant, 1996; Ginsberg et al., 1999), while others reported reduction of TC and TG with an increase of HDL-C (Robinson et al., 1998; Yki-Jarvinen et al., 1999). Still other studies showed no changes in lipid profile (Groop et al., 1998; Rains et al., 1998). Another investigation showed an association of met ... Continue reading---
REFRENCES - [ Total Page(s): 3 ]Rodger, W. (2012). Sulphonylureas and heart disease in diabetes management. Diabetes Spectrum. Pg. 12–27.Rosenbaum, M. and Leibel, R. L. (2014). Role of leptin in energy homeostasis in humans. Journal of Endocrinology. 223(1): 83-96.Rowley, D.E. and Bezold, D.C. (2012). Using new insulin strategies in the outpatient treatment of diabetes: clinical applications. Journal of American Medical Association. Pg. 289.Shaw, D., De Rosa, N. and Di Maro, G. (2010). Metformin improves glucose, lipid ... Continue reading---
