Effect of adding glitazone or sulphonylurea derivate in obese patients with type 2 diabetes mellitus treated by metformine
Abstract
Type 2 diabetes mellitus represents a very heterogenic group of diseases with a variably manifested impairment of insulin sensitivity (insulin resistance) and/or an impairment of insulin secretion (insulin deficiency). The treatment of patients resistant to insulin is based primarily on lifestyle changes as well as administration of metformine; depending on the grade of prevailing impairment it is possible to improve the insulin sensitivity by adding glitazone or to improve impaired insulin secretion by adding sulphonylurea derivate.
The clinical benefit of adding thiazolidinedione or sulphonylurea secretagogue in 20 obese patients with type 2 diabetes mellitus treated until then by metformine was assessed retrospectively. Clinical parameters (weight, body mass index - BMI, blood pressure), parameter of diabetic compensation (glycated hemoglobin HbA1c), lipid spectrum (triacylglycerole levels; total, HDL and LDL cholesterol) and liver function tests during metformine treatment and 1 year following the addition of glitazone/sulphonylurea derivate to existing treatment were assessed.
A statistically significant improvement of metabolic compensation in both groups and a decrease of total and LDL cholesterol levels in glitazone group were achieved. A statistically significant weight gain was seen in the group with added sulphonylurea derivate.
Other parameters were not influenced. Education of diabetic patients, physical activity and weight reduction are the essential factors of the treatment of type 2 diabetes mellitus.