Title : Evaluation of pancreatic function by comparing insulin sensitivity in Type 2 Diabetes Mellitus (T2DM) patients two centers prospective study
Abstract:
Background: Diabetes is a major global health concern, with T2DM accounting for 90% of cases. T2DM is marked by declining insulin secretion and resistance. Recent studies suggest insulin plus metformin may be more effective than oral agents plus metformin in preserving beta-cell function and improving insulin sensitivity in T2DM.
Objectives: To evaluate the impact of combined insulin and metformin vs. metformin combined OHAs on pancreatic function of T2DM patients by comparing insulin sensitivity between two groups. Additionally, to compare glycemic control by measuring hemoglobin A1c (HbA1c) levels, changes in body mass index (BMI), and incidence of hypoglycemic episodes in both treatment groups.
Methods: An Observational, prospective, two-centered setting. Allocating T2DM patients on combined insulin and metformin vs. metformin combined OHAs. The C-peptide, fasting insulin level, fasting blood glucose (FBG), HbA1c, weight and height and number of hypoglycemic attacks during the 3 months are parameters collated at baseline and after 3 months. The homeostatic model assessment for insulin resistance (HOMA-IR) was calculated for all patients.
Results: The first group was with 31 individuals (35%) treated with insulin and metformin, while 57 patients (65%) were on OHA and metformin. The insulin and metformin group exhibited higher insulin fasting values and lower C-peptide levels at baseline and after 3 months (p<0.05). Whereas the OHA and metformin group exhibited a higher reading for HOMA-IR after 3 months (p=0.359). Furthermore, a minor reduction in BMI, HbA1c and FBG values were observed in both groups after 3 months (p>0.05).
Conclusion: Our study concludes that patients on metformin and OHA have superiority effect on pancreatic function demonstrated in C-peptide levels compared to metformin and OHA, however, this difference is no significant in insulin sensitivity as calculated by HOMA-IR between groups.
