Comparison of 3 Medicine Groups Used to Control Glycemic and Glycated Hemoglobin Levels in Newly Diagnosed Type 2 Diabetes Patients
DOI:
https://doi.org/10.3889/oamjms.2021.4672Keywords:
Glycemic, Diabetes, Hypoglycemia, Dipeptidyl peptidase-4, Sulfonylurea, MetforminAbstract
AIM: This research aims to compare the effectiveness of three medicines groups in controlling glycemic and glycated hemoglobin (HbA1c) levels in the newly diagnosed diabetes mellitus type 2.
METHODS: One hundred fifty newly diagnosed patients with type 2 diabetes were treated by mono therapy and divided into three groups. Each group of 50 patients was treated by one medicine: Group 1 using Diamicron MR 30 mg (Sulfonylurea) – three capsules per day, Group 2 using metformin 500 mg – 1–3 capsules per day, and Group 3 using Januvia (sitagliptin, dipeptidyl peptidase-4 inhibitor) 100 mg – 1 capsule per day. The evaluation of glucose control was based on fasting plasma glucose and HbA1c concentration and divided into three levels: Excellent, good, and poor. The assessment was carried out after every 3 months of treatment, at 3rd month, 6th month, and 12th month (WHO, 2002).
RESULTS: After treatment 3, 6, and 12 months, glucose level was decreased when compared to before treatment in all three groups (pall < 0.001). At the month 6th, the groups treated by sulfonylurea and sitagliptin had lower glucose level than metformin (with p values were 0.04 and 0.01, respectively), and maintained the low glucose level from the month 6th to month 12th (with p values were 0.71 and 0.77, respectively) while glucose level of the metformin group increased (p = 0.005). HbA1c has decreased dramatically in all three groups after treatment (p values of sulfonylurea group at the month 3rd, 6th, and 12th vs. before treatment were 0.006, 0.021, and 0.001, respectively; all p values of metformin group at the month 3rd, 6th, and 12th vs. before treatment were below 0.001; all p values of sitagliptin group at the month 3rd, 6th, and 12th vs. before treatment were below 0.001). The group treated by sitagliptin got the highest ratio of excellent HbA1c control (82% after 12 months of treatment).
CONCLUSION: Significant improvement of glucose and HbA1c levels was observed in all three groups. Glucose control level of group treated with sulfonylurea was markedly improved and the group treated with sitagliptin achieved optimal control of HbA1c.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Punthakee Z, Goldenberg R, Katz P. Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Can J Diabetes. 2018;42(Suppl 1):S10-5. https://doi.org/10.1016/j.jcjd.2017.10.003 PMid:29650080
Ritz E, Rychlik I, Locatelli F, Halimi S. End-stage renal failure in Type 2 diabetes: A medical catastrophe of worldwide dimensions. Am J Kidney Dis. 1999;34(5):795-808. https://doi.org/10.1016/s0272-6386(99)70035-1 PMid:10561134
del Canizo-Gomez FJ, Moreira-Andres MN. Cardiovascular risk factors in patients with type 2 diabetes. Do we follow the guidelines? Diabetes Res Clin Pract. 2004;65(2):125-33. https://doi.org/10.1016/j.diabres.2003.12.002 PMid:15223224
Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, et al. Consensus statement by the american association of clinical endocrinologists and american college of endocrinology on the comprehensive Type 2 diabetes management algorithm--2016 executive summary. Endocr Pract. 2016;22(1):84-113. https://doi.org/10.4158/ep-2018-0108 PMid:26731084
Davies MJ, D’Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. 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). Diabetes Care. 2018;41(12):2669-701. https://doi.org/10.2337/dci18-0033 PMid:30291106
Chan SP, Colagiuri S. Systematic review and meta-analysis of the efficacy and hypoglycemic safety of gliclazide versus other insulinotropic agents. Diabetes Res Clin Pract. 2015;110(1):75- 81. https://doi.org/10.1016/jdiabres.2015.07.002 PMid:26361859
Khunti K, Chatterjee S, Gerstein HC, Zoungas S, Davies MJ. Do sulphonylureas still have a place in clinical practice? Lancet Diabetes Endocrinol. 2018;6(10):821-32. https://doi.org/10.1016/s2213-8587(18)30025-1 PMid:29501322
Nauck MA, Meier JJ, Cavender MA, Abd El Aziz M, Drucker DJ. Cardiovascular actions and clinical outcomes with glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors. Circulation. 2017;136(9):849-70. https://doi.org/10.1161/circulationaha.117.028136 PMid:28847797
World Health Organization. Type 2 Diabetes Practical Targets and Treatments 2002 (Targets for Control). Geneva: World Health Organization; 2002.
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabetic Med. 1998;15(7):539-53. https://doi.org/10.1002/ (sici)1096-9136(199807)15:7<539::aid-dia668>3.0.co;2-s PMid:9686693
American Diabetes Association. 6. glycemic targets: Standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S66-76. https://doi.org/10.2337/dc20-s006 PMid:31862749
United Kingdom Prospective Diabetes Study (UKPDS). 13: Relative efficacy of randomly allocated diet, sulphonylurea, insulin, or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. BMJ. 1995;310(6972):83-8. https://doi.org/10.1136/bmj.310.6972.83 PMid:7833731
Hermann LS, Schersten B, Bitzen PO, Kjellstrom T, Lindgarde F, Melander A. Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations. A double-blind controlled study. Diabetes Care. 1994;17(10):1100-9. https://doi.org/10.2337/diacare.17.10.1100 PMid:7821128
Li CJ, Liu XJ, Bai L, Yu Q, Zhang QM, Yu P, et al. Efficacy and safety of vildagliptin, Saxagliptin or Sitagliptin as add-on therapy in Chinese patients with Type 2 diabetes inadequately controlled with dual combination of traditional oral hypoglycemic agents. Diabetol Metab Syndrome. 2014;6:69. https://doi.org/10.1186/1758-5996-6-69 PMid:24917890
Ommen ES, Xu L, O’Neill EA, Goldstein BJ, Kaufman KD, Engel SS. Comparison of treatment with sitagliptin or sulfonylurea in patients with Type 2 diabetes mellitus and mild renal impairment: A post hoc analysis of clinical trials. Diabetes Ther. 2015;6(1):29-40. https://doi.org/10.1007/s13300-015-0098-y PMid:25633134
Shankar RR, Xu L, Golm GT, O’Neill EA, Goldstein BJ, Kaufman KD, et al. A comparison of glycaemic effects of sitagliptin and sulfonylureas in elderly patients with Type 2 diabetes mellitus. Int J Clin Pract. 2015;69(6):626-31. https://doi.org/10.1111/ijcp.12607 PMid:25652751
Griffin SJ, Leaver JK, Irving GJ. Impact of metformin on cardiovascular disease: A meta-analysis of randomised trials among people with Type 2 diabetes. Diabetologia. 2017;60(9):1620-9. https://doi.org/10.1007/s00125-017-4337-9 PMid:28770324
Aeronautical Development Agency. Standarts of medical care in diabetes. Diabetes Care. 2019;42:66.
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of Type 2 diabetes (UKPDS 35): Prospective observational study. BMJ. 2000;321(7258):405-12. https://doi.org/10.1136/bmj.321.7258.405 PMid:10938048
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2021 Ngoc Chau Nguyen, Hoai Thuong Pham, Diep Thao Pham, Thi Minh Hoang, Thi Phuong Lan Dam, Thi Hang Ho, Duy Quy Dang, Nhu Binh Do, Quang Thuan Huynh (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0
