Outcomes of Metformin on Lipid Profile of Type II Diabetes Mellitus Cases in Tertiary Care Hospital
INTRODUCTION:-Metformin acts mainly at the liver by reducing glucose output and secondarily, by augmenting glucose uptake in the peripheral tissues, primarily muscle. These effects are facilitated by the activation of an upstream kinase, liver kinase B1 (LKB-1), which in turn controls the downstream kinase adenosine monophosphates protein kinase (AMPK). AMPK phosphorylates a transcriptional co-activator, transducer of regulated CREB protein 2, resulting in its inactivation which consequently down regulates transcriptional events that promote synthesis of gluconeogenic enzymes
METHODOLOGY:- 200 total numbers of cases were included of diabetic mellitus who received 1500mg/day metformin. The duration of study was one year.
RESULT:- In results observed that decrease in fasting blood glucose, total cholesterol, LDL- C and TGs. HDL-C levels were increased significantly after treatment.
Therefore, the findings of the present study concluded that metformin used in diabetic treatment improves lipid profile.
2. Burestin, M, Selvenick, H.R., Morfin, R. 1970. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. Lipid Res., 11: 583-583.
3. Freedman, D.S., Dietz, W.H., Srinivasan, S.R., Berenson, G.S. 1999. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics, 103: 1175-82.
4. Gower, B.A. 1999. Syndrome X in children: influence of ethnicity and visceral fat. Am. J Hum. Biol., 11: 249-57.
5. Goldberg, I.J. 2001. Clinical review 124: Diabetic dyslipidemia: causes and consequences. J. Clin. End. Metab., 86: 965-971.
6. Godarzi MO, Brier-Ash M: Metformin revisited: reevaluation of its properties and role in the pharmacopoeia of modern antidiabetic agents. Diabetes Obes Metab. 2005, 5: 654-665.
7. Shaw RJ, Lamia KA, Vasquez D: The kinase LKB1 mediates glucose homeostasis in liver and therapeutic effects of metformin. Science. 2005, 310: 1642-1646. 10.1126/science.1120781.
8. El-Mir MY, Nogueira V, Fontaine E: Dimethyl biguanide inhibits cell respiration via an indirect effect targeted on the respiratory chain complex I. J Biol Chem. 2000, 275: 223-228. 10.1074/ jbc.275.1.223.
9. Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004, 27: 1047-1053. 10.2337/diacare.27.5.1047.
10. Manzella D, Grella R, Esposito K, Giugliano D, Barbagallo M, Paliosso G. Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration. Am J Hypert 2004;17:223-227.
11. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention of metformin. N Engl J Med 2002;346:393-403.
12. UK Prospective Diabetes study Group. Effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998;352:854-865.
13. Beisswenger P, Ruggiero-Lopez, D. Metformin inhibition of glycation processes. Diabetes Metab 2003;29:6S95-6S103.
14. Mamputu JC, Wiernsperger NF, Reiner G. Antiatherogenic properties of metformin: the experimental evidence. Diabetes Metab 2003;29:6S71-6S76.
15. Weitgasser R. Effects of glimepiride on HbA1c and body weight in Type 2 diabetes: results of a 1.5-year follow-up study, Diabetes research and clinical practice. 2003;61:13-19.
16. Inglea P and Taleleb G. Effects of metformin in combination with glimepiride on HbA1c and body mass index inIndian patients with type 2 diabetes mellitus, Journal of Pharmacy Research. 2010; 3(9):2177-2179.
17. Min W. Effect of short-term intensive therapy with glimepiride and metformin in newly diagnosed type 2 diabetic patients J. South Med Univ. 2011;31:564-566.
18. Charpentier G, Fleury F, Kabir M, Vaur L and Halimi S., Improved glycaemic control by addition of glimepiride to metformin monotherapy in Type 2 diabetic patients, Diabetic Medicine. 2001;18:828-834.
19. Moses R. Effect of repaglinide addition to metformin monotherapy onglycemic control in patients with type 2 diabetes. Diabetes Care. 1999;22:119-124.
20. Ramachandran A, Snehalatha C, Salini J and Vijay V. Use of Glimepiride and Insulin Sensitizers in the Treatment of Type 2 Diabetes. A Study in Indians, JAPI. 2004;52:459-463.
21. Haupt E, Knick B, Koschinsky T, Liebermeister H, Schneider J and Hirche H. Oral antidiabetic combination therapy with sulphonylureas and metformin. Diabetes Metab. 1991;17:224-31.
22. Riddle M. Combining sulfonylureas and other oral agents. Am J Med. 2000;108(Suppl) 6a:15S-22S.
23. Salpeter SR, Greyber E, Pasternak GA and Salpeter EE. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus: systematic review and meta-analysis. Arch Intern Med. 2003;163:2594.
24. Kim HJ. Effects of rosiglitazone and metformin on inflammatory markers and adipokines: decrease in interleukin-18 is an independent factor for the improvement of homeostasis model assessmentbeta in type 2 diabetes mellitus,Clin. Endocrinol. (Oxf.) 2007;66(2):282-9.
25. Riccio A, Del Prato S, De Kreutzenberg SV and Tiengo A. Glucose and lipid metabolism in non-insulin dependent diabetes: effect of metformin. Diabetes Metab. 1991;17:180–184.
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