Abstract
Background:Dyslipidaemia is a global health issue in developed as well as in developing countries. People with type 2 Diabetes mellitus are more susceptible to develop dyslipidaemia and its related complications.The objective of the study was to assess the effect of sitagliptin a (DPP-4 inhibitor) oral antidiabetic drug on blood sugar, body weight, blood pressure and dyslipidaemia in type 2 diabetic patients.Methods:This 12 weeks open label observational study was conducted atoutdoor of diabetic clinic of Sheikh Zayed Medical College/Hospital, Rahim Yar Khanin whichnewly diagnosed type 2 diabetic patients(n=78) with poor glycaemic control(HbA1c >7.2%) were selected. The patient received sitagliptin 50mg twice daily for 12 weeks.Results:After 12 weeks treatment with sitagliptin, there was a significant reduction in the value ofHbA1c from8.184%±0.467 at baseline to 7.0200%±0.459at 12 weeks (p<0.05). Body weight also decreased significantly from80.21kg±7.156 at baseline to 71.74kg±6.567 at 12 weeks (p<0.05).Systolic blood pressure decreased (SBP) decreased significantly from 138.17±6.050mmHg at baseline to 131.22±6.311 mmHg at 12 weeks (p<0.05). Significantchanges were also seen in diastolic blood pressure which decreased from 83.14±6.714 mmHg at baseline to 75.28±6.481mmHg at 12 weeks (p<0.05). Significant reduction in the serum level of total Cholesterol (TC), triglycerides (TG) and Low density lipoprotein cholesterol(LDL-C) were detected(TC: 222.09±13.538 to 209.41±13.475 mg/dl,p<0.05; TG: 170.99±6.940 to 143.45±8.279 mg/dl,p<0.05; LDL-C 120.00±5.804 to 109.06±6.278 mg/dl, p<0.05). High density lipoprotein cholesterol (HDL-C) increased significantly from42.99±4.836 mg/dl at baseline to 49.97±3.490 mg/dl at 12 weeks.Conclusion: Sitagliptin not only improves blood glucose control but alsobody weight,bloodpressure and lipid profile in type 2 diabetic hyperlipidaemia patientsKeywords: Sitagliptin, Diabetes Mellitus, HbA1c, Blood pressure, Lipid profile, body weightJ Ayub Med Coll Abbottabad 2016;28(2):369–72INTRODUCTIONCardiovascular disease, in the form of atherosclerosis,is presently a leading cause of death and global challenge all across the world.Lipid disorders are well recognizedrisk factor in the development and pathogenesis of atherosclerosis.When atherosclerosis occurs in the coronary arteries, it may lead to angina and myocardial infarction; but when it occurs in the cerebral vessels it produces very bad consequences such as stroke and transient ischemic attacks. In addition, intermittent claudication and gangrene are the two important complications of atherosclerosis when it involves the peripheral vessels. The global burden of cardiovascular disease in the form of atherosclerosis may be expected to the foremost cause of death and early disability in 2020.1The lipid abnormalities are characterized by elevation of total cholesterol (TC), low density lipoprotein cholesterol (LDL cholesterol) and triglycerides (TG) and the level of high density lipoprotein cholesterol (HDL cholesterol) is low. The high levels of TC, TG, LDL cholesterol and low level of HDL cholesterol in plasma in various epidemiological, clinical, genetic and experimental studies indicate thehigher risk of angina, myocardial infarction and stroke.2Patients who are having type 2 diabetes mellitus are more liable to develop dyslipidaemia as compared to type 1 diabetes. This diabetic dyslipidaemia is characterized by high plasma triglycerides concentration, increase concentration of small dense LDL cholesteroland low HDL cholesterol level. High blood pressure, excess weight and high serum glucose level are additional risk factors in type 2 diabetic patients that contribute significantly in atherosclerosis and its related complications likeischemic heart disease and peripheral artery disease.3Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor belongs to incretin mimetics, a class of antidiabetic drugs that shows different mechanism of action than usual anti diabetic drugs. Two very important intestinal hormones glucagon like peptide-1 (GLP-1) and glucose dependent insulinotropic peptide (GIP) are released after taking meal. They trigger the release of insulin, inhibit glucagon secretion, and delaygastric emptying and increase satiety.4This Incretin stimulated insulin release depends upon the level of
Mazhar Hussain, , Moazzam Ali Atif, Ali Gull Tunio, Barkat Ali, Lubna Akhtar, , Ghulam Serwar, Ghulam Serwar. (2016) EFFECT OF SITAGLIPTIN ON GLYCEMIC CONTROL, BODY WEIGHT, BLOOD PRESSURE AND SERUM LIPID PROFILE IN TYPE 2 DIABETIC HYPERLIPIDEMIC PATIENTS, JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD, Volume 28, Issue 2.
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