Comparison of metformin and repaglinide monotherapy in the management of newly diagnosed diabetes mellitus type 2: a prospective study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20241171Keywords:
Comparison, Diabetes mellitus, Diagnosed, Type 2, Repaglinide, Newly, Management, Metformin, MonotherapyAbstract
Background: Diabetes Mellitus Type 2 (DMT2), which is characterized by the raised blood sugar level due to insulin resistance in body cells, has now become global epidemic. This study was aimed to compare the efficacy of metformin and repaglinide monotherapy in patients with newly diagnosed DMT2.
Methods: This randomized comparative prospective study was performed in a tertiary care hospital of Lahore. 108 Patients’ enrollment was made via simple random sampling technique and a developed inclusion and exclusion criteria. Patients were divided into metformin and repaglinide groups via lottery method. Self-designed proforma was applied for data collection. Data analysis was done in SPSS version 25.0.
Results: There was no significant difference in the means of pretreatment (p=0.08) and posttreatment (p=0.10) fasting blood sugar levels between two groups, while significant differences between the means of pretreatment and posttreatment fasting blood sugar levels within metformin group (p=0.02) and repaglinide group (p=0.01) were noted. Likewise, there was no significant difference in the means of pretreatment (p=0.07) HbA1C levels of two groups; however, significant difference was observed in the means of posttreatment (p=0.04) HbA1C of two groups. Moreover, significant differences were also seen between the means of pretreatment and posttreatment HbA1C levels in both metformin group (p=0.03) and repaglinide group (p=0.01).
Conclusions: This study suggests that although both metformin and repaglinide are effective in the new-onset T2DM managementz; however, reduction in fasting blood sugar level and HbA1c was more in repaglinide group.
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References
Sadeeqa S, Fatima M, Latif S, Afzal H, Nazir SU, Saeed H. Prevelance of metformin-induced gastrointestinal problems. Acta Poloniae Pharmaceutica-Drug Res. 2019;76(6):1073-7.
Akhtar S, Khan Z, Rafiq M, Khan A. Prevalence of type II diabetes in District Dir Lower in Pakistan. Pak J Medi Sci. 2016;32(3):622.
Ma J, Liu LY, Wu PH, Liao Y, Tao T, Liu W. Comparison of metformin and repaglinide monotherapy in the treatment of new onset type 2 diabetes mellitus in China. J Diab Res. 2014;2014.
Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38(1):140-9.
Wei F, Chang B, Yang X, Wang Y, Chen L, Li WD. Serum uric acid levels were dynamically coupled with hemoglobin A1c in the development of type 2 diabetes. Sci Rep. 2016;6(1):28549.
Bai XU, Tan JB, Feng NI, Sun JP, Zhang KY, Li LI, et al. Association between serum uric acid and prevalence of type 2 diabetes diagnosed using HbA1c criteria among Chinese adults in Qingdao, China. Biomed Environm Sci. 2015;28(12):884-93.
Ghari Arab A, Zahedi M, Kazemi Nejad V, Sanagoo A, Azimi M. Correlation between hemoglobin a1c and serum lipid profile in type 2 diabetic patients referred to the diabetes clinic in Gorgan, Iran. J Clin Basic Res. 2018;2(1):26-31.
Care D. Standards of medical care in diabetes 2019. Diabetes Care. 2019;42(Suppl 1):S124-38.
Tamez-Pérez HE, Proskauer-Peña SL, Hernández-Coria MI, Garber AJ. AACE comprehensive diabetes management algorithm 2013 endocrine practice/in response. Endoc Pract. 2013;19(4):736.
UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998;352(9131):854-65.
Scarpello JH, Howlett HC. Metformin therapy and clinical uses. Diab Vasc Dis Res. 2008;5(3):157-67.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes care. 2014 Jan 1;37(Supplement_1):S81-90.
Li Y, Xu L, Shen J, Ran J, Zhang Y, Wang M, Yan L, Cheng H, Fu Z. Effects of short-term therapy with different insulin secretagogues on glucose metabolism, lipid parameters and oxidative stress in newly diagnosed type 2 diabetes mellitus. Diab Res Clin Pract. 2010;88(1):42-7.
Derosa G, Mugellini A, Ciccarelli L, Crescenzi G, Fogari R. Comparison of glycaemic control and cardiovascular risk profile in patients with type 2 diabetes during treatment with either repaglinide or metformin. Diab Res Clin Pract. 2003;60(3):161-9.
Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: variations with increasing levels of HbA1c. Diab Care. 2003;26(3):881-5.
Skyler JS, Bergenstal R, Bonow RO, Buse J, Deedwania P, Gale EA, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. Circulation. 2009;119(2):351-7.
Younas A, Riaz J, Chughtai T, Maqsood H, Younus S, Qasim M, et al. Comparison of metformin and repaglinide monotherapy in the treatment of new-onset type 2 diabetes mellitus. Cureus. 2021;13(1).
Fang FS, Gong YP, Li CL, Li J, Tian H, Huang W, et al. Comparison of repaglinide and metformin monotherapy as an initial therapy in Chinese patients with newly diagnosed type 2 diabetes mellitus. Euro J Endocrinol. 2014;170(6):901-8.
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