Abstract
This study aimed to compare the effects of metformin and glibenclamide on high sensitivity serum C-reactive protein (hs-CRP) and oxidative stress, represented by serum malondialdehyde (MDA) and total antioxidant status (TAS) in newly-diagnosed patients with Type 2 diabetes mellitus (DM) at baseline and after 2 months of therapy in comparison to controls. The subjects, recruited from Al-Wafaa Centre for Diabetes Management and Research, Iraq, November 2009 to January 2011, were 103 newly-diagnosed Type 2 DM patients; 53 were prescribed metformin and 50 glibenclamide. The control group was 40 apparently healthy volunteers. Blood samples were taken from all subjects after overnight fasting. Sera were separated and assays of hs-CRP, MDA and TAS were done. After 2 months monotherapy, the blood samples and assays were repeated. There were significant differences between patients prescribed metformin and glibenclamide and the controls with regard to serum hs-CRP, MDA and TAS. There was a significant reduction in the serum MDA and a significant raise in the serum TAS levels, with no significant effects on serum hs-CRP levels after metformin therapy, but no significant effects on these parameters after glibenclamide therapy. The percentage of variation in these parameters after both drugs, showed a significant raise in serum TAS levels with the metformin therapy with no significant effects in serum MDA and hs-CRP. Metformin positively affected the oxidant/antioxidant balance in newly-diagnosed Type 2 DM patients with no significant effects on acute phase reaction protein. Glibenclamide had no significant effects on oxidant/antioxidant balance and acute phase reaction protein.
Highlights
This study aimed to compare the effects of metformin and glibenclamide on high sensitivity serum C-reactive protein and oxidative stress, represented by serum malondialdehyde (MDA) and total antioxidant status (TAS) in newly-diagnosed patients with Type 2 diabetes mellitus (DM) at baseline and after 2 months of therapy in comparison to controls
There was a significant reduction in serum MDA with a significant rise in the serum TAS levels and an insignificant effect on serum hsCRP after metformin therapy [Table 3]
In regard to metformin therapy, our findings were in accordance with the results of previous studies,[18,19,20] while the results of the glibenclamide therapy were in agreement with the study conducted by Yudkin, et al who found that markers of acute phase activation measured by concentrations of CRP in patients with Type II DM were not significantly influenced by SU.[21]
Summary
Abstract: Objectives: This study aimed to compare the effects of metformin and glibenclamide on high sensitivity serum C-reactive protein (hs-CRP) and oxidative stress, represented by serum malondialdehyde (MDA) and total antioxidant status (TAS) in newly-diagnosed patients with Type 2 diabetes mellitus (DM) at baseline and after 2 months of therapy in comparison to controls. Metformin is recommended as an oral hypoglycemic core therapy in diabetes management worldwide and the guidelines of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) recommend its use in patients irrespective of age, body weight and degree of baseline hyperglycaemia, due to its favourable effect on metabolic indices of glucose, lipid, and weight control.[10] On the other hand, glibenclamide is a well-known second generation sulfonylurea (SU) that has been the mainstay for treatment of patients with Type II DM for years.[11] The aim of this study was to assess and compare the effects of metformin and glibenclamide on acute phase protein (represented by high sensitivity serum C-reactive protein [hs-CRP]) and on oxidative/antioxidant status (represented by serum malondialdehyde [MDA] and total antioxidant status [TAS]) in newlydiagnosed patients with Type II DM at baseline and after 2 months of therapy
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