Dyslipidemia Associated with Poor Glycemic Control in Type 2 Diabetes Mellitus and the Protective Effect of Metformin Supplementation

Abstract

The nature of the dyslipidemia associated with diabetes mellitus is complex and is the major risk factor for atherosclerosis and coronary artery disease. Aim of this study was to assess the effect of glycemic control, achieved by metformin, glibenclamide and insulin, on lipid profile in type 2 diabetic patients. One hundred and sixty-five type 2 diabetes mellitus patients were classified into good glycemic control (Group I) and poor glycemic control (Group II) on the basis of their blood HbA1c values. The Group II was characterized with high serum triglyceride (190.46 ± 15.20 mg/dl), total cholesterol (175.3 ± 6.31 mg/dl) as well as high LDL-cholesterol (109.0 ± 5.88 mg/dl). Significant correlations were evident between HbA1c and dyslipidemia, particularly serum TG (r = 0.28, P < 0.05), and between HbA1c and total cholesterol (r = 0.310, P < 0.05). Better glycemic control and improved dyslipidemia were observed in patients on combination therapy of metformin plus glibenclamide.

Profiles of Liver Function Tests among Type 2 Diabetic Patients Who are Receiving Different Anti-Diabetic Drugs Attending Tikur Anbessa Specialized Hospitals

“…On the contrary HDL was increased in insulin alone receiver group. Similar results were reported by Mullugeta et al [17] in which the patients on insulin therapy appeared to have slightly lower cholesterol levels but addition of metformin to the management protocol resulted in a significant improvement in the serum cholesterol. Addition of metformin not only decreased the total cholesterol levels but also had a positive effect on the distribution of cholesterol between HDL (increase) and LDL lipoproteins (decrease).…”

“…Another result also reported by Mullugeta et al [17] in which the patients on insulin therapy showed LDL higher than glibenclamide plus metformin therapy. The mean values of TC, TG and HDL levels were decreased in insulin treated patients than glibenclamide treated group but not statistically significant.…”

“…On the contrary, value of LDL in insulin receiver group is higher than glibenclamide group which was statistically significant as shown in Table 4. Mullugeta et al [17] reported similar results in which higher total cholesterol concentrations in the patients taking glibenclamide only. But, the present work is not in agreement with their report lowered LDL and HDL in glibenclamide received group than insulin group.…”

“…Regardless of drug management, the pancreatic beta-cells in type 2 diabetic patients continue to deteriorate leading to worsening glycemic control and consequent requirement for multiple therapies or exogenous insulin [17].…”

Design, Synthesis and Preliminary Pharmacological Evaluation of New Metformin Derivatives

“…Metformin plays an effective role in the treatment of polycystic ovary syndrome [2], cardiovascular disease [3], dyslipidemia [4] and in cancer treatment [5].…”