Influence of glimepiride plus sitagliptin on treatment outcome, blood glucose, and oxidative stress in diabetic patients

Abstract

Objective: This research sets out to investigate the influence of glimepiride (GLIM) plus sitagliptin (SITA) on the treatment outcome, blood glucose (BG), and oxidative stress (OS) in diabetic patients.

Methods: In this retrospective study, 189 patient cases of type 2 diabetes mellitus (T2DM) admitted from July 2017 to July 2021 to the Affiliated Hospital of Nantong University were selected, of whom 99 cases treated with GLIM + SITA were assigned to the research group (RG) and 90 cases receiving GLIM monotherapy were set as the control group (CG). The two cohorts of patients were compared in terms of treatment outcomes, BG, islet function, OS, inflammatory responses (IRs), and safety. The BG indexes detected mainly included fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG) and glycosylated hemoglobin (HbA1c). Islet function was mainly measured by Homeostasis Model Assessment of β-cell Function (HOMA-β) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). The OS parameters measured primarily included malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX). Tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-18 were the inflammatory factors measured.

Results: A statistically higher excellent or good rate of treatment was determined in the RG compared to the CG. After treatment, FBG, 2hPG, HbA1c, HOMA-IR, MDA, TNF-α, IL-6, and IL-18 were lower in the RG while HOMA-β, SOD, and GSH-PX were higher, compared to the levels before treatment and the CG. A non-significantly different incidence of adverse reactions between groups was determined.

Conclusions: Our findings demonstrated high efficacy of GLIM + SITA in the treatment of T2DM patients, which can effectively improve the BG and OS of patients and reduce inflammation without increasing the incidence of adverse reactions. This should have high clinical application value.

Keywords: Glimepiride; blood glucose; diabetes; inflammatory response; oxidative stress; sitagliptin; treatment outcome.

Figure 1

Blood glucose of diabetic patients. A. FBG of diabetic patients. B. 2hPG of diabetic patients. C. HbA1c of diabetic patients. Note: * represents P<0.05 compared to the level before treatment; “a” represents P<0.05 compared to the control group. FBG, fasting blood glucose; 2hPG, 2-hour postprandial blood glucose; HbA1c, glycosylated hemoglobin.

Figure 2

Islet function in diabetic patients. A. HOMA-β in diabetic patients. B. HOMA-IR in diabetic patients. Note: * represents P<0.05 compared to the level before treatment; “a” represents P<0.05 compared to the control group. HOMA-β, Homeostasis Model Assessment of β-cell Function; HOMA-IR, Homeostasis Model Assessment of Insulin Resistance.

Figure 3

Oxidative stress in diabetic patients. A. MDA in diabetic patients. B. SOD in diabetic patients. C. GSH-PX in diabetic patients. Note: * represents P<0.05 compared to the level before treatment; “a” represents P<0.05 compared to the control group. MDA, malondialdehyde; SOD, superoxide dismutase; GSH-PX, glutathione peroxidase.

Figure 4

Inflammatory markers in diabetic patients. A. TNF-α in diabetic patients. B. IL-6 in diabetic patients. C. IL-18 in diabetic patients. Note: * represents P<0.05 compared to the level before treatment; “a” represents P<0.05 compared to the control group. TNF, tumor necrosis factor; IL, interleukin.