Abstract
Aim: The complications associated with diabetes and the new trend of using combination therapy in the management of the disease gave birth to this work, aimed at assessing the hepatotoxic and nephrotoxic effects of selected popularly used antidiabetic medications in type 2 diabetic patients within Ota, Ogun State, Nigeria.
 Study Design: The participants, diabetic (n=195) and non-diabetic (n=30) were divided into the following groups based on their medications: 1 (Non Diabetic control), 2 (Metformin), 3 (Glimepiride), 4 (Glibenclamide), 5 (Metformin and Glimepiride), 6 (Meformin and Glibenclamide), 7 (Metformin, Glimepiride and Glibenclamide) and 8 (Diabetic Dietary control).
 Methodology: Serum protein expression profiling, liver and kidney function parameters were assessed in participant’s blood using Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and standard laboratory methods respectively.
 Results: Glyceamic control within the diabetic groups was 29.23%. Urea concentration was significantly increased (p < 0.05) in groups 5 and 7 compared with groups 1 and 8 while the serum creatinine levels in the different groups showed no significant difference. Activities of alkaline phosphatase and aspartate aminotransferase increased significantly (p < 0.05) in group 5 compared with groups 1 and 8. A low molecular weight protein likely to be Leptin (molecular weight 18 kDa) was over-expressed in all the diabetic groups.
 Conclusion: This study shows that use of multiple rather than single drugs caused significant functional changes in the liver and kidney. The control of diabetes may best be carried out with dietary control and lifestyle modification as well as good therapeutic drug monitoring for safe assessment of baseline organ function.
Highlights
Diabetes mellitus is an endemic metabolic disease characterised with hyperglycemia; which can be due to either the inability of the pancreas to produce enough insulin, or inability of cells to respond to the insulin produced
There was significant difference (p < 0.05) in the concentration of albumin in diabetic groups using glibenclamide and in the group using metfomin and glimepiride, while there was no significant difference (p > 0.05) in the diabetic groups using metformin; glimepiride; metformin and glibenclamide and in the group using metformin, glimepiride and glibenclamide when compared with diabetic dietary control group (Table 3)
There was significant increase (p < 0.05) in the concentration of alkaline phosphatase (ALP) in diabetic groups using metformin; glimepiride; glibenclamide; metformin and glimepiride; and metformin and glibenclamide, while there was no significant difference (p > 0.05) in the concentration of ALP only in diabetic group using combination therapy metformin, glimepiride and glibenclamide when compared with diabetic dietary control group (Table 3)
Summary
Diabetes mellitus is an endemic metabolic disease characterised with hyperglycemia; which can be due to either the inability of the pancreas to produce enough insulin, or inability of cells to respond to the insulin produced. It is a complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycemic control [1]. Various genetic and environmental factors can result in the progressive loss of β-cell mass and/or function that manifests clinically as hyperglycemia in both type I and type II diabetes [3]. The leading cause of this metabolic disorder in Africa today include: aging population, increased urbanization; which can be due to changes in life style, dietary intake, lack of physical exercise, physiological stress, which is associated with obesity, a great risk factor of diabetes [4]
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