Study of lipid lowering effects of oral antidiabetic drugs in type 2 diabetes mellitus patients

Authors

  • Shashikala E. Department of Pharmacology, Mallareddy Institute of Medical Sciences, Hyderabad, Telangana, India
  • Somnath Motgi Department of Pharmacology, Mallareddy Institute of Medical Sciences, Hyderabad, Telangana, India
  • Raghawa Rao B. N. V. Department of Cardiology, Mallareddy Institute of Medical Sciences, Hyderabad, Telangana, India
  • Mohd Abdul Sattar Department of Diabetology, Mallareddy Institute of Medical Sciences, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20175687

Keywords:

Affordable, Lipid profile, Lipid lowering effects, Oral antidiabetic drugs, T2DM

Abstract

Background: Type 2 diabetes mellitus (T2DM) is one of the most common non-communicable diseases associated with ‘atherogenic dyslipidemia’ The treatment of T2DM often is initiated with oral antidiabetic drugs, most of which not only decrease blood sugar levels effectively but also decrease the lipid levels. Hence the current study is aimed to determine the effectiveness of oral hypoglycemic agents in dealing with associated dyslipidemia.

Methods: 150 T2DM patients were divided equally into five groups depending upon the oral antidiabetic drugs they received in solo or in combination for 24 weeks, with equal number of males and females in each group. After the written consent, a detail clinical history, clinical examination, Biochemical investigations including, glycosylated haemoglobin and lipid profile, chest X-ray and ECG were done.

Results: After 24 weeks of study, the mean total cholesterol and mean triglycerides decreased significantly (p <0.05 to p <0.01) with monotherapy of metformin and teneligliptin as well as with combination of either metformin and glimepiride or metformin and teneligliptin. The decrease of LDL-C and VLDL-C was not statistically significant with any of the OAD drugs in solo or in combination. Similarly, HDL-C increased significantly (p <0.05) in Group I, III, IV and V; but was most effective with combination therapy. The atherogenic index of plasma also decreased (p <0.05) with metformin or its combination with either teneligliptin or glimepiride.

Conclusions: Oral antidiabetic drugs are not only affordable and effective hypoglycemic agents but can also decrease serum lipids and thereby aids in the prevention and management of atherosclerosis and its complications in T2DM.

References

American Diabetes Association. Role of cardiovascular risk factors in prevention and treatment of macrovascular disease in diabetes. Diabetes Care. 1993;16:72-8.

Smyth S, Heron A. Diabetes and obesity: the twin epidemics. Nature medicine. 2006;12(1):75-80.

Ahlawat SK, Singh MM, Kumar R, Kumari S, Sharma BK. Time trends in the prevalence of hypertension and associated risk factors in Chandigarh. J Indian Med Assoc. 2002;100(9):547-52.

Kumar A, Nagtilak S, Sivakanesan R, Gunasekera S. Cardiovascular Risk Factors in Elderly Normolipidemic Acute Myocardial Infarct Patients- A Case Controlled Study from India. Southeast Asian J Trop Med Public Health. 2009;40(3):581-92.

American Diabetes Association. Standard of Medical care in Daibetes-2016. Diabetes Care. 2016;39:S1-S106.

Richmond W. Preparation and Properties of a Cholesterol Oxidase from Nocardia species and its application to the enzymatic assay of Total Cholesterol in serum. Clin Chem. 1973;19:1350-6.

Foosati P, Prencipe L. Serum triglycerides determined calorimetrically with an enzyme that produces hydrogen peroxide. Clin Chem. 1982;28:2077-80.

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499-502.

Haupt E, Knick B, Koshinsky T, Liebermeister H, Schneider J and Hirche H. oral antidiabetic combination therapy with Sulphonylurea and metformin. Diabet Metab. 1991;17:224-31.

Riddle M. Combining sulphonylureas and other oral agents. Am J Med. 2000;1086a:155-225.

Kim MK, Rhee EJ, Han KA, Woo AC, Lee MK, Ku BJ, et al. Efficacy and safety of teneligliptin, a dipeptidyl peptidase‐4 inhibitor, combined with metformin in Korean patients with type 2 diabetes mellitus: a 16‐week, randomized, double‐blind, placebo‐controlled phase III trial. Diabetes, Obesity and Metabolism. 2015;17(3):309-12.

Gibbons GF. Hyperlipidemia of diabetes mellitus. Clin Sci. 1988;71:477-86

Abbasi F, Kamath V, Rizvi AA, Carantoni M, Chen YD, Reaven GM. Results of a placebo-controlled study of the metabolic effects of the addition of metformin to sulfonylurea-treated patients: evidence for a central role of adipose tissue. Diabet care. 1997;20(12):1863-9.

Cagatay P, Susleyici-Duman B, Alasya H, Ipbuker A. Effects of oral antidiabetic drugs over lipid parameters in Turkish type 2 diabetes patients. Acta Med Acad. 2009;38(2):77-85.

Ginsberg H, Plutzky J, Sobel BE. A review of metabolic and cardiovascular effects of oral antidiabetic agents: beyond glucose level lowering. J Cardiovasc Risk. 1999;6:337-46.

Grant PJ. The effects of high-and medium-dose metformin therapy on cardiovascular risk factors in patients with type II diabetes. Diabetes care. 1996 Jan 1;19(1):64-6.

Yki-Järvinen H, Ryysy L, Nikkilä K, Tulokas T, Vanamo R, Heikkilä M. Comparison of Bedtime Insulin Regimens in Patients with Type 2 Diabetes MellitusA Randomized, Controlled Trial. An Int Med. 1999;130(5):389-96.

Robinson AC, Burke J, Robinson S, Johnston DG, Elkeles RS. The effects of metformin on glycemic control and serum lipids in insulin-treated NIDDM patients with suboptimal metabolic control. Diabet Care. 1998;21(5):701-5.

Groop L, Widen E, Franssila-Kallunki A, Ekstrand A, Saloranta C, Schalin C, et al. Different effects of insulin and oral antidiabetic agents on glucose and energy metabolism in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1989;32(8):599-605.

Rains SG, Wilson GA, Richmond W, Elkeles RS. The effect of glibenclamide and metformin on serum lipoproteins in type 2 diabetes. Diabet Med. 1988;5(7):653-8.

Ansar S, Koska J, Reaven PD. Postprandial hyperlipidemia, endothelial dysfunction and cardiovascular risk: focus on incretins. Cardiovasc diabetol. 2011;10(1):61.

Fukuda-Tsuru S, Anabuki J, Abe Y, Yoshida K, Ishii S. A novel, potent, and long-lasting dipeptidyl peptidase-4 inhibitor, teneligliptin, improves postprandial hyperglycemia and dyslipidemia after single and repeated administrations. Eur J Pharmacol. 2012;696(1):194-202.

Zhu H, Zhu S, Zhang X, Guo Y, Shi Y, Chen Z, Leung SW. Comparative efficacy of glimepiride and metformin in monotherapy of type 2 diabetes mellitus: meta-analysis of randomized controlled trials. Diabet Metab Synd. 2013;5(1):70.

Wulffele MG, Kooy A, de Zeeuw D, Stehouwer CD, Gansevoort RT. The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic review. J Int Med 2004;256:1-14.

Garimella S, Seshayamma V, Rao HJ, Kumar S, Kumar U, Saheb SH. Effect of Metformin on Lipid profile of type II Diabetes. Int J Intg Med Sci. 2016;3(11):449-53.

Ingle PV, Talele DG. Comparative effects of metformin in combination with glimepiride and glibenclamide on lipid profile in indian patients with type 2 diabetes mellitus. Age. 2011;47:45.

Seuring T, Archangelidi O, Suhrcke M. The economic costs of type 2 diabetes: a global systemic review. Pharmacoeconom. 2015;33(8);811-31.

Nathan DM, Buse JB, Davidson MB, Heine RJ, Holman RR, Sherwin R, et al. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabet care. 2006;29(8):1963-72.

Downloads

Published

2017-12-23

How to Cite

E., S., Motgi, S., B. N. V., R. R., & Sattar, M. A. (2017). Study of lipid lowering effects of oral antidiabetic drugs in type 2 diabetes mellitus patients. International Journal of Basic & Clinical Pharmacology, 7(1), 126–132. https://doi.org/10.18203/2319-2003.ijbcp20175687

Issue

Section

Original Research Articles