Comparison of 3 Medicine Groups Used to Control Glycemic and Glycated Hemoglobin Levels in Newly Diagnosed Type 2 Diabetes Patients

Abstract

AIM: This research aims to compare the effectiveness of three medicines groups in controlling glycemic and glycated hemoglobin (HbA1c) levels in the newly diagnosed diabetes mellitus type 2.
 METHODS: One hundred fifty newly diagnosed patients with type 2 diabetes were treated by mono therapy and divided into three groups. Each group of 50 patients was treated by one medicine: Group 1 using Diamicron MR 30 mg (Sulfonylurea) – three capsules per day, Group 2 using metformin 500 mg – 1–3 capsules per day, and Group 3 using Januvia (sitagliptin, dipeptidyl peptidase-4 inhibitor) 100 mg – 1 capsule per day. The evaluation of glucose control was based on fasting plasma glucose and HbA1c concentration and divided into three levels: Excellent, good, and poor. The assessment was carried out after every 3 months of treatment, at 3rd month, 6th month, and 12th month (WHO, 2002).
 RESULTS: After treatment 3, 6, and 12 months, glucose level was decreased when compared to before treatment in all three groups (pall < 0.001). At the month 6th, the groups treated by sulfonylurea and sitagliptin had lower glucose level than metformin (with p values were 0.04 and 0.01, respectively), and maintained the low glucose level from the month 6th to month 12th (with p values were 0.71 and 0.77, respectively) while glucose level of the metformin group increased (p = 0.005). HbA1c has decreased dramatically in all three groups after treatment (p values of sulfonylurea group at the month 3rd, 6th, and 12th vs. before treatment were 0.006, 0.021, and 0.001, respectively; all p values of metformin group at the month 3rd, 6th, and 12th vs. before treatment were below 0.001; all p values of sitagliptin group at the month 3rd, 6th, and 12th vs. before treatment were below 0.001). The group treated by sitagliptin got the highest ratio of excellent HbA1c control (82% after 12 months of treatment).
 CONCLUSION: Significant improvement of glucose and HbA1c levels was observed in all three groups. Glucose control level of group treated with sulfonylurea was markedly improved and the group treated with sitagliptin achieved optimal control of HbA1c.