-
The Effect Of Antidiabetic Agent Glibenclamide And Meltformine On Lipids And Glycated Haemoglobin In Type 2 Diabetes Patient Attending Uith Ilorin
CHAPTER FIVE -- [Total Page(s) 2]
Page 1 of 2
-
-
-
CHAPTER FIVE
5.0 DISCUSSION
The 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 metformin with an improvement in the lipid profile even in non-diabetic patients (DeFronzo and Goodman, 1995). New studies are needed to clarify this issue, since TG and HDL-C are very important parameters for the evaluation of metabolic syndrome. A possible reason for these discrepant results may be that the clinical studies cited above analyzed data from independent samples. In our study, this problem was avoided by paired data analysis, in which each patient was his own control, thereby increasing the power of the statistical analysis.
A recent meta-analysis (Wulffele, 2004) covering 41 studies on the effects of metformin on BP and lipid profile showed that only TC reduction was significant. This study was in agreement with these findings and show that this fact was independent of BMI and WC reduction. Since the TG reduction found in the present study underwent interference from BMI and WC (intervening variables), we cannot conclude that metformin had a direct and isolated effect on TG levels.
The glycated haemoglobin level in control which do not take any type of anti-diabetic drugs has been statistically significant elevated as compared with those with type 2 diabetes i.e. (with metformin therapy) and (with metformin plus glibenclamide therapy). This result was in agreement with Krishna et al. (2015) who have demonstrated that anti- diabetic drugs such as metformin and glibenclamide produced a significant decrease in glycated haemoglobin levels compared to pre-treatment values (Krisha et al., 2015). On the other hand, there was no significant difference between those with metformin therapy and those with metformin plus glibenclamide therapy. This result is agreeing with Marwan (2013) who have demonstrated that there were no significant differences in those with metformin plus glibenclamide therapy between metformin treated group and those treated by a combination therapy of metformin plus glibenclamide (Al- Naama et al., 2010).
This results in agreement with Reyadh (2012) who found that use of metformin/glibenclamide combination or metformin alone in the treatment of T2DM maintained cholesterol levels closer to normal levels and in combination therapy serum TC level was lower than metformin used alone (Reyadh et al., 2012). Triglyceride results was found not to be significantly elevated (p<0.05) in those with metformin therapy when compared with control group this result was not in agreement with Attalah (2007) who found increase level of serum triglycerides in diabetic patients, which could be due to the increase of hepatic triglyceride synthesis (Attalah, 2007). Subjects with metformin therapy and those with metformin plus glibenclamide therapy showed no significant differences when compared to the control group. These results were in agreement with Kassim (2011) who found that metformin and glibenclamide therapies produces a non-significant favorable effect on serum triglyceride (Kassim, 2011). Type 2 diabetes is characterized by low HDL cholesterol (HDL-C) and HDL dysfunction (Al-Amery et al., 2013). The precise cause of the low HDL-C in type 2 diabetes is not known but may be the consequence of insulin resistance, augmented very low density lipoprotein production and increased activities of cholesteryl ester transfer protein and hepatic lipase (Fadini et al., 2014). Cagatay et al. (2011) found that using metformin as a mono therapy or combination with glibenclamide in type 2 diabetics produce no significant effect on HDL-C (Barter, 2011). The results of serum low density lipoprotein for diabetic patients with metformin therapy was found to be significantly different (p≤0.05) when compared with control group. Singh and Kumar (2011) found that the level of LDL significantly higher in type 2 diabetics (Cagatay et al., 2009). Increased elimination of lipids and apolipoproteins from VLDL particles results in the increased production of intermediate density lipoprotein (IDL) and LDL (Singh and Kumar, 2011). Dailey et al. (2002) found that combination therapy of metformin and glibenclamide shows a favorable effect on LDL-C levels and closer to that of nondiabetic subjects (Dailey et al., 2002). Petrovic et al. (2010) study revealed a significant elevation in VLDL-C when compared diabetic patients with controls. This may be due to insulin resistance has striking effects on lipoprotein size and subclass particle concentrations for VLDL and that lead to increased hepatic secretion of VLDL-C in type 2 diabetic patients (Petrovic et al., 2010), while Reyadh et al. (2012) who found a no significant difference between metformin and metformin plus glibenclamide treated groups compared with control group (Rosenbaum and Leibel, 2014; Ibrahim et al., 2015; Mohammed et al., 2016).
CHAPTER FIVE -- [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 ONE - [ Total Page(s): 2 ]The present study was designed to investigate and compare the effects of glibenclamide and metformin on prevalence of metabolic syndrome in type 2 diabetic patients.1.2 STATEMENT OF PROBLEMTo know if antidiabetic agents glibenclamide and meltformine has any effect on lipid and glycated haemoglobin in type 2 diabetes patients1.3 AIM OF STUDYTo evaluate the effect of antidiabetic agent glibenclamide and meltformine on lipids and glycated haemoglobin in type 2 diabetes patient attendi ... 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---
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---
