The impact of metformin adding therapy on type 2 DM patient on insulin treatment

Abstract

Background:

   The need for strict glycemic, lipid and blood pressure control  to avoid or delay the development of  cardiovascular and other complications in those with type 2 DM has been well established.

Aim of study:

   To assess the   the role of metformin medication on the blood glucose control, improvemen of lipid profile,  blood pressure contole and  body weight  of patient with type 2 diabetic patients .

Patient and method:   

   A cohort study was done to assess 50 patients of type 2 diabetes mellitus , on insulin therapy , seen at diabetic Centre of Al Sadr city in Al-najaf Alashraf . All patients were followed up monthly for 3 months to insure regular treatment and occurrence of any complication .

 Results

    Fifty patients with  type 2 diabetic  were studed by using a paired analysis study those patient ordinerary on insulin therapy then we added  maximum dose of metformin therapy  on insulin  then followed after 3 monts 3 after metformin therapy ( combination insulin and metformin therapy) to assess and evaluate the effect of metformin as combination  therapy with insulin on the blood glucose control, Triglyceride level ,total cholesterol and blood pressure . in addition to assessment of HA1C and blood glucose level we also assess other parameter including metformin therapy effect on systolic and diastolic blood pressure ,Waist ciecumfrence, body mass index(BMI),lipid profile for each patient.This study was a  cohort study  to review and asess  type 2 DM  patients on insulin  . in this study we found that blood glucose level was   significantly improved (P < 0.001) after the introduction a amaximum dose of metformin therapy  (2000 mg/day), and a 30 % of the fifty  type 2 diabetic patients reaching HbA1c levels less than 7%, and 50% of patients reaching HA1c values (7-8%) . There was  also significant reduction of triglyceride level with  (P < 0.05) and  TG (286.8 ± 56.6 to 221.04 ± 33.43 mg/dL) and reduction of waist circumference  (124.5 ±  11.8 to  117.4 ± 9.4 cm) but there was  no significant improvement   in total cholesterol level , HDL cholesterol, blood pressure and body mass index .

Conclusion:

   This study evaluate  the effect  of metformin adminstration with  insulin therapy simultaneously without important negative side effects with significant  glycemic and TG control and waist circumference reduction.