Effect of Metformin with & without Vildagliptin on Renal Function in Type 2 Diabetes Patients Enrolled in BIRDEM Hospital

Abstract

Diabetes Mellitus is one of the major causes of renal impairment and a major public health problem globally. Diabetes is associated with microvascular complications that also includes nephropathy. Diabetes nephropathy is the leading cause of renal failure in such patients. Diabetes Mellitus is one of the major causes of renal impairment and a major public health problem globally. Adequate glycemic control is essential to prevent or delay the onset of diabetic nephropathy. There are availability of antidiabetic medications in the market. However, only a few can be used safely in patients suffering from both diabetes and chronic kidney disease. Metformin has been recommended as the first line antidiabetic drug recommended by the American Diabetes Association. If a single agent is failed to achieve adequate glucose control, a combination oral antidiabetics may result in better glycemic control in patients with Type 2 diabetes. This study was designed to assess the efficacy and safety of metformin without vildagliptine (M without V)) and metformin with vildagliptine (M with V)in type 2 diabetic patients on blood glucose and renal function. During eight months study period, 600 prescription (Diabetic Books prescription and new patients initial form prescription) of patients suffering from diabetes mellitus were analyzed from BIRDEM, Shahabag, Dhaka, Bangladesh. Patients suffering from Type 2 diabetes, male or female, age ≥22 years were included in the study. The patients were prescribed Metformin with and without vildagliptin and also other combination drugs for the treatment of diabetes. The present study shows that the fasting blood glucose of the patients of M without V was 8.838 ± 2.145 mmol/L and M with V was 9.231 ± 3.475 mmol/L. The difference was not statistically significant (p=0.8504). The blood glucose level after 2 hours breakfast (ABF) was 12.81 ± 2.942 mmol/L in M without V group and 12.02 ± 4.315 mmol/L in M with V group (p=0.022). The creatinine value of M without V group was 1.075 ± 0.92 mg/dl and M with V was 1.011±0.246. The difference between the group is not statistically significant (p=0.507). Metformin with and without Vildagliptin effectively control fasting blood glucose level in type 2 diabetes patients. The blood glucose level after 2 hour breakfast is better controlled by Metformin with Vildagliptin. Metformin with and without Vildagliptin has no significant effect on creatinine level. Further study is needed with a large sample size to determine the efficacy and safety of combination Metformin and Vildagliptin in type 2 diabetes patients.