Effect of combined Metformin and Esomeprazole therapy on plasma gastrin and blood glucose in elderly patients with type 2 diabetes mellitus

Abstract

Objective To investigate the effect of combined Metformin and esomeprazole therapy on plasma levels of gastrin, blood glucose, glycosylated hemoglobin(HbA1c)and insulin in elderly patients with type 2 diabetes. Methods A randomized, double-blind, placebo-controlled study of 41 elderly patients with type 2 diabetes was conducted.Patients were randomly assigned into treatment group(combination therapy with Metformin 0.5 g, bid or tid and Esomeprazole 20 mg, qd, for 12 weeks)and placebo group(Metformin monotherapy 0.5 g, bid or tid, for 12 weeks). Fasting blood samples were taken from vein before and after treatment.Fasting serum levels of gastrin, glucose, HbA1c, insulin, lipids, liver and renal functions were compared between the two groups.The homeostasis model of assessment for insulin resistance index(HOMA-IR)and insulin secretion index(HOMA-β)were calculated, and complications were recorded. Results There were no significant differences in body mass index and waist circumference between the two groups.Serum gastrin level was slightly increased in the treatment group 12 weeks after treatment, but without statistically significance 〔(127.20±9.21)ng/L vs.(131.53±7.84)ng/L, P>0.05〕, and serum gastrin level had no significant differences in the placebo group before and after treatment 〔(128.42±4.58)ng/L vs.(127.51±3.47)ng/L, P>0.05〕. However, there were no significant differences in the changes of blood glucose, HbA1c, insulin, HOMA-β and HOMA-IR before versus after therapy, and between the two group(all P>0.05). Conclusions Combined Metformin and insulin therapy cannot increase serum gastrin and insulin levels and has no significant effect on reducing blood glucose and HbA1c levels in elderly patients with type 2 diabetes. Key words: Diabetes mellitus, type 2; Proton pump inhibitor; Metformin; Gastrins; Blood glucose