To compare the anti-inflammatory effect of oral hypoglycemic drugs in type 2 diabetes mellitus

Abstract

Insulin resistance and endothelial dysfunction which shares multiple signaling pathways likehyperinsulinemia, glucotoxicity and inflammation in type 2 Diabetes Mellitus (DM) leads to several micro and macrovascular complications. Studies have shown the antiinflammatory effects of certain oral hypoglycemic agents which will be helpful in preventing the impact of diabetes related complications. The study aimed to compare the anti-inflammatory effects of Sitagliptin and Acarbose in combination with Metformin and Sulfonylurea in Type2DM patients by using Anti-inflammatory markers Interleukin-6 (IL6), high sensitive C-reactive protein (hsCRP) and also to compare the clinical outcome between these two groups by using the parameters Fasting blood sugar (FBS), Post prandial blood sugar (PPBS), hemoglobin A1c (HbA1C), Plasma Insulin. In this open labeled prospective parallel group clinical study 30 type 2 diabetes patients on Metformin and Sulfonylurea combination, with HbA1c value >/=7.5 were recruited in tertiary care hospital and divided into two groups based on their HbA1C levels and were added on either Acarbose or Sitagliptin along with Metformin Sulfonylurea combinations and were followed for 3 months. Parameters like FBS, PPBS, HbA1c, Plasma Insulin hs CRP, IL-6were measured before and after the study. In the study the mean value of FBS, PPBS, HbA1c, Plasma Insulin, Insulin Resistance, hsCRP were reduced in both Sitagliptin and Acarbose group, which were similar to the results of previous studies except IL6 which got reduced in Sitagliptin group but increased in Acarbose group. The study had showed the synergism of Sitagliptin with Metformin Sulfonylurea combinationin reducing inflammation however; still long term studies are required to confirm their anti-inflammatory effects.