Estimation of Serum Creatinine, Aspartate Aminotransferase, Alanine Transaminase, and Hemoglobin A1c% Levels among Diabetic Patients using Metformin/Dipeptide Peptidase-4 Inhibitor Combination and Insulin – A Cross-Sectional Study
DOI:
https://doi.org/10.3889/oamjms.2022.9003Keywords:
Metformin, Dipeptide peptidase-4 inhibitor combination, Insulin, Diabetes mellitus, Aspartate aminotransferase, Alanine transaminase, Serum creatinine, Hemoglobin A1cAbstract
BACKGROUND: Diabetes is a leading cause of morbidity and mortality worldwide, imposing a considerable burden on health systems and societies as it affects both individuals and their families and has a large impact on the economic and social development of a country. Nowadays, to treat diabetes, patients are taking drugs such as metformin in combination with dipeptide peptidase-4 (DPP-4) inhibitors and insulin for their treatment. There are many physiological and pathological changes while taking drugs for treating diabetes.AIM: Through this research, we can have an idea about the health of the patient and help to detect the level in which different drugs are affecting the patient’s kidney and liver.
METHODS: A cross-sectional study was done on diabetes type 1 and type 2 diabetic patients who are undergoing treatment with insulin and DPP-4 inhibitors/metformin combination drugs. The study continued for 3 months including preparation, practice, and data analysis.
RESULTS: In this study, our results show there is no significant change in all biochemical parameters: aspartate aminotransferase (AST), alanine transaminase, creatinine, and hemoglobin A1c (HbA1c) between diabetic patients treated with insulin and metformin/DPP-4 combination.
CONCLUSION: Metformin/DPP-4 combination gives a better glycemic control than other medications, whereas the levels of AST, creatinine, and HbA1c are unaffected using either insulin or metformin/DPP-4 inhibitors combination.Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Boyle JP, Honeycutt AA, Narayan KM, Hoerger TJ, Geiss LS, Chen H, et al. Projection of diabetes burden through 2050: Impact of changing demography and disease prevalence. Diabetes Care 2018;24(11):36-40. DOI: https://doi.org/10.2337/diacare.24.11.1936
Mohamed J, Nafizah AH, Zariyantey AH, Budin SB. Mechanisms of diabetes-induced liver damage: The role of oxidative stress and inflammation. Sultan Qaboos Univ Med J. 2016;16(2):132-41. https:// doi.org/10.18295/squmj.2016.16.02.002 PMid:27226903 DOI: https://doi.org/10.18295/squmj.2016.16.02.002
Wang Q, Long M, Qu H, Shen R, Zhang R, Xu R, et al. DPP-4 inhibitors as treatments for type 1 diabetes mellitus: A systematic review and meta-analysis. J Diabetes Res. 2018;18:132-41. https://doi.org/10.1155/2018/5308582 PMid:29507862 DOI: https://doi.org/10.1155/2018/5308582
Hoofnagle JH. Clinical and research information on drug-induced liver injury. In: Liver Tox. Vol. 3. United States: Bethesda, National Institute of Diabetes and Digestive and Kidney Diseases; 2012. p. 873-4.
DeFronzo R, Fleming GA, Chen K, Bicsa TA. Metformin-associated lactic acidosis: Current perspectives on causes and risk. Metabolism. 2015;65(2):20-9. https://doi.org/10.1016/j.metabol.2015.10.014 PMid:26773926 DOI: https://doi.org/10.1016/j.metabol.2015.10.014
Home P, Riddle M, Cefalu WT, Bailey CJ, Bretzel RG, Prato SD, et al. Insulin therapy in people with type 2 diabetes: Opportunities and challenges? Diabetics Care. 2014;37(6):1499-508. https://doi.org/10.2337/dc13-274 PMid:24855154 DOI: https://doi.org/10.2337/dc13-2743
Ahrén B. Novel combination treatment of type 2 diabetes DPP-4 inhibition + metformin. Vasc Health Risk Manag. 2008;4(2):383-94. https://doi.org/10.2147/vhrm.s1944 PMid:18561513 DOI: https://doi.org/10.2147/VHRM.S1944
Busch M, Nadal J, Schmid M, Paul K, Titze S, Hübner S, et al. Glycaemic control and antidiabetic therapy in patients with diabetes mellitus and chronic kidney disease-cross-sectional data from the German Chronic Kidney Disease (GCKD) cohort. BMC Nephrol. 2016;17:59. DOI: https://doi.org/10.1186/s12882-016-0273-z
Cheng P, Hsu S, Kuo J, Cheng Y, Liu Y, Tu S. Comparing the effect of dipeptidyl-peptidase 4 inhibitors and sulfonylureas on albuminuria in patients with newly diagnosed type 2 diabetes mellitus: A prospective open-label study. J Clin Med. 2019;8(10):1715. https://doi.org/10.3390/jcm8101715 PMid:31627406 DOI: https://doi.org/10.3390/jcm8101715
Coppolino G, Leporini C, Rivoli L, Ursini F, Di Paola ED, Cernaro V, et al. Exploring the effects of DPP-4 inhibitors on the kidney from the bench to clinical trials. Pharmacol Res. 2018;129:274-94. https://doi.org/10.1016/j.phrs.2017.12.001 PMid:29223646 DOI: https://doi.org/10.1016/j.phrs.2017.12.001
Lee YK, Song SO, Lee HC, Cho Y, Choi Y, Yun Y, et al. Glycemic effectiveness of metformin-based dual-combination therapies with sulphonylurea, pioglitazone, or DPP4-inhibitor in drug-naïve Korean type 2 diabetic. Diabetes Metab J. 2013;37(6):465-74. https://doi.org/10.4093/dmj.2013.37.6.465 PMid:2440451 DOI: https://doi.org/10.4093/dmj.2013.37.6.465
Rathish D, Jayasumana C, Agampodi S. Comparison of biochemical parameters among DPP4 inhibitor users and other oral hypoglycaemic drug users: A cross-sectional study from Anuradhapura, Sri Lanka. J Health Popul Nutr. 2019;23(1):3. https://doi.org/10.1186/s41043-019-0160-x PMid:30674350 DOI: https://doi.org/10.1186/s41043-019-0160-x
Brackett CC. Clarifying metformin’s role and risks in liver dysfunction. J Am Pharm Assoc (2003). 2010;50(3):407-10. https://doi.org/10.1331/JAPhA.2010.08090 PMid:20452916 DOI: https://doi.org/10.1331/JAPhA.2010.08090
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2022 Arshiya Shadab, Ilma Hussain, Praveen Kumar Kandakurti, Marwan Ismail, Ahmed Luay Osman Hashim, Salah Eldin Omar Hussein, Altoum Abd Elgadir (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0
