Macrovascular and microvascular complications in type 2 diabetic Iraqi patients treated by metformin and glibenclamide versus metformin and sitagliptin

الملخص EN

Background : in type 2 diabetes mellitus there is a progressive loss of beta cell function.

One new approach yielding promising results is the use of the orally active dipeptidyl peptidase-4 (DPP-4) inhibitors for type 2 diabetes mellitus.

Objective : this study aims at comparing the possible occurrence of macro vascular & micro vascular complications in Iraqis patients with type 2 diabetes mellitus using two combinations of drugs metformin + glibenclamide and metformin + sitagliptin.

Methodology : Sixty eight T2DM patients and 34 normal healthy individuals as control group were enrolled in this study and categorized in to two treatment groups.

The group 1 (34 patients ) received metformin 500 mg three times daily + glibenclamide 5 mg twice daily and the group 2 (34 patients) received metformin 500 mg three times daily + sitagliptin 100 mg once daily.

The urine sample was collected for estimation of microalbumin urea and patients' examination was made by specialist consultant endocrinologist.

Results : the percentages of microalbuminurea were significantly (p < 0.05) lower for group 2 patients for 3 & 6 months of treatment (9.3 %, 8.5 %) respectively compared to group 1 (22.13 %, 18.12 %) respectively.

The percentages of parasthesia, numbness and burning sensation of feet was significantly (p < 0.05) lower for group 2 patients for 3 & 6 months of treatment(16.71 %, 8.71 %) (20.59 %, 8.53) and (13.3, 7.54) respectively as compared to group 1 (39.7 %, 34.36), (35.18, 29.29) and (31.18 %, 37.88 %).

The picture was same for postural hypotension & ischemic heart disease the percentages were significantly (p < 0.05) lower for group 2 patients for 3 & 6 months of treatment (7.12 %, 8.82 %) and (11.76 %, 8.82 %) respectively as compared to group 1 (18.76 %, 14.65 %) and (17.65 %, 14.7 %) respectively.

The same was true for simple and proliferative retinopathy the percentages were significantly (p < 0.05) lower for group 2 patients for 3 & 6 months of treatment (6.22 %, 7.83 %) and (2.82 %, 2.7 %) respectively as compared to group 1 (15.76 %, 14.65 %) and (7.71 %, 6.65 %) respectively Recommendations : combination of metformin + sitagliptin significantly lower micro vascular and macro vascular complications than combination of metformin + glibenclamide.