Compliance and efficacy of extended release Metformin and immediate release thrice daily Metformin in type-2 Diabetes Mellitus- A comparative study

Autor: Dr.Sunil kumar, Amit Kumar, Jitendra Kumar, Vandana, Subrata Nag
Rok vydání: 2014
Předmět:
Zdroj: IOSR Journal of Dental and Medical Sciences. 13:19-22
ISSN: 2279-0853
2279-0861
DOI: 10.9790/0853-13731922
Popis: Aim of study: Metformin is a first-line pharmacological treatment for patients with type 2 diabetes mellitus because of its favorable overall profile, including its glucose-lowering ability, weight-neutral effects, and low risk of hypoglycemia; however, gastrointestinal (GI) intolerance may limit use in some patients. Extendedrelease metformin improves GI tolerability, allows once-daily dosing,improves compliance in patients. Conclusion: Patients with type 2 DM who had been receiving thrice daily MIR achieved comparable glycemic control when therapy was switched to once or twice daily MXR at the same daily dose. I. Introduction Metformin hydrochloride has been widely used as an effective and generally well-tolerated glucoselowering agent for >40 years and is the most frequently prescribed first-line therapy for patients with type 2 diabetes . Metformin typically reduces basal and postprandial hyperglycemia by ∼25% in >90% of patients when given alone or with other therapies during a program of managed care. An extended release formulation (MXR approved in October 2000 allows once daily dosing. This newer formulation release the active drug through active hydrated polymers which expand after uptake of fluids. This prolongs gastric residence time. Extended-release metformin showed slightly lower maximum concentrations, longer times to maximum concentration (7–8 vs. 4–5 h), and similar bioavailability compared with immediate-release products. This extended release could potentially reduce dosing frequency to once daily compared with two or three times daily for immediate-release formulations. which produces slower drug action in the upper GI tract allowing once a day dosing. II. Materials And Methods We conducted a clinical trial involving 75 patients with T2DM who were on at least 1 gm of MIR with or without other antihyperglycemic agents. Eligibility criteria included an age of atleast 40 years, a BMI of 20 or higher, and fasting capillary glucose of 1.4 mg% for women) hepatic dysfunction, congestive heart failure, major psychiatric disorder ,alcohol and/ or substance abuse ,seizure disorders, or a history of malignancy or steroid intake, pregnant or breastfeeding women were excluded from the study. Patients could be receiving long term insulin therapy or any other anti hyperglycemic therapy apart from MIR. After a lead in period of three months, during which patients were on weight maintenance diet and 1000-2000mg of MIR (in 2 or 3 divided doses) all patients who were at least 80% compliant with the drug treatment(as determined by tablets count and interviews) were entered in the study. At the visit of trial(visit 0) all eligible patients with T2DM were switched over to one particular brand of MIR while the dose of MIR and other hypoglycemic agents were kept the same. Baseline measurement included a two point glucose profile (Fasting, 2 hour PP), Serum Lipid profile (Total Cholesterol), low density lipoprotein cholesterol (LDL), High Density Lipoprotein (HDL) and Triglycerides (TG) are concentrations, standard laboratory tests (haematology, serum chemistry profile, urine analysis) and electrocardiography (ECG). A record of body weight, blood pressure and other vital signs were maintained. After one month (Visit 1) a subjects were assessed and then switched over to 500mg lesser dose of MXR which was given in the form of a single dose after dinner. Whereas the other antihyperglycemic agents were continued. Patients were subsequently called for 3 or more monthly intervals.
Databáze: OpenAIRE
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