Metformin-insulin versus metformin-sulfonylurea combination therapies in type 2 diabetes: A comparative study of glycemic control and risk of cardiovascular diseases in addis ababa, ethiopia

10Citations
Citations of this article
86Readers
Mendeley users who have this article in their library.

Abstract

Objective: This study aimed to compare glycemic control and risk of cardiovascular outcomes of metformin-insulin versus metformin-sulfonylurea combination therapies in type 2 diabetes mellitus. Methods: We conducted a comparative cross-sectional study in five tertiary level hospitals in Addis Ababa, Ethiopia. We enrolled 321 patients with type 2 diabetes mellitus who were on continuous treatment follow-up on either metformin-insulin or metformin-sulfonylurea combination therapy. We interviewed the participants and reviewed their medical records to investigate medication efficacy, safety, and adherence. The primary outcome measure was glycemic control and the secondary outcome measures were composite cardiovascular outcomes. Results: Of the total participants enrolled, 50.5% (n = 162) were those who received metformin-insulin and 49.5% (n = 159) metformin-sulfonylurea combination therapies for a median of 48 months follow-up. The reduction of Hb1Ac levels was comparable between the metformin-insulin (−1.04 ± 0.96%) and metformin-sulfonylurea (−1.02 ± 1.03%), p = 0.912. Patients who received metformin-sulfonylurea had 4.3 times more likely to have achieved target HbA1c level compared to those who received metformin-insulin, p < 0.001, adjusted odds ratio (AOR) with 95% CI = 4.31[1.79–10.32]. Risk of composite cardiovascular outcomes was higher in metfor-min-insulin group (40.5% versus 34.0%), p = 0.021. Co-morbidities, body mass index, systolic blood pressure, and HbA1c had a significant association with composite cardiovascular out-comes. Reductions of bodyweight, HDL-C, LDL-C, triglycerides levels, and microvascular complications were different between the two groups, p < 0.05. Conclusion: High proportion of patients who received metformin-sulfonylurea achieved target HbA1c level and had less composite cardiovascular outcomes compared to those who received metformin-insulin. However, these findings have to be confirmed with randomized control trials to determine risks associated with insulin use, while efficacy is maintained as second-line treatment in patients with type 2 diabetes mellitus.

References Powered by Scopus

Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)

18930Citations
N/AReaders
Get full text

Blood pressure lowering for prevention of cardiovascular disease and death: A systematic review and meta-analysis

2636Citations
N/AReaders
Get full text

Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the european association for the study of diabetes (EASD)

2074Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Development of a solvent-free micellar HPLC method for determination of five antidiabetic drugs using response surface methodology

19Citations
N/AReaders
Get full text

HIV Protease Inhibitors and Insulin Sensitivity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

14Citations
N/AReaders
Get full text

The societal impact of early intensified treatment in patients with type 2 diabetes mellitus

7Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Gebrie, D., Manyazewal, T., Ejigu, D. A., & Makonnen, E. (2021). Metformin-insulin versus metformin-sulfonylurea combination therapies in type 2 diabetes: A comparative study of glycemic control and risk of cardiovascular diseases in addis ababa, ethiopia. Diabetes, Metabolic Syndrome and Obesity, 14, 3345–3359. https://doi.org/10.2147/DMSO.S312997

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 14

61%

Lecturer / Post doc 6

26%

Researcher 2

9%

Professor / Associate Prof. 1

4%

Readers' Discipline

Tooltip

Medicine and Dentistry 9

39%

Pharmacology, Toxicology and Pharmaceut... 6

26%

Nursing and Health Professions 4

17%

Biochemistry, Genetics and Molecular Bi... 4

17%

Article Metrics

Tooltip
Social Media
Shares, Likes & Comments: 1

Save time finding and organizing research with Mendeley

Sign up for free