September 2017 Vol. 5 No.9

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Original Research Article

Effects of Metformin, Sulfonyurea, and Insulin Therapy on Serum Insulin and Insulin Resistance in Type 2 Diabetic Subjects

^*1Maduka Ignatius C., ²Eze Blessing, ¹Ogueche Nnamdi P. and ²Egwu Mary

¹Department of Human Biochemistry, Nnamdi Azikiwe University, Nnewi campus, Anambra state, Nigeria
²Department of Medical Laboratory Science Nnamdi Azikiwe University, Nnewi campus, Anambra state, Nigeria

*Corresponding author e-mail: madukaig@yahoo.com
Tel: 234-80-33180616

Accepted August 30, 2017

Abstract

Type 2 diabetes mellitus is an endocrine metabolic disorder that is associated with insufficient insulin production from the pancreatic beta cells, and insulin resistance. The prevalence of this disorder is increasing both in developed and underdeveloped countries. Objective: Management of diabetes mellitus have been tailored to life style changes and synthetic anti-diabetic therapy. These synthetic drugs may affect the normal serum insulin level and insulin resistance which might increase the progression of the disease. This study was therefore conducted to evaluate the effect of metformin, sulfonylurea, and insulin therapy on serum insulin and insulin resistance in type 2 diabetic subjects. A total of 198 subjects (aged 35 to 70 years) (test) and 99 apparently healthy subjects (control) were recruited for the study. The test subjects were further grouped into 5: Group A were diabetics on metformin and sulfonylurea combination therapy, group B were diabetics on metformin monotherapy, group C were diabetics on metformin and insulin combination therapy, group D were diabetics on insulin monotherapy and group E were diabetics not on any anti-diabetic drug. FBS and lipid profile were estimated by enzymatic end point method, serum insulin was estimated by ELISA method while insulin resistance was calculated by homeostatic model assessment (HOMA) method. The result of this study showed that there was statistical significant difference in the mean level of FBS among the five groups (p = 0.005). The post hoc analysis of this result shows that FBS was significantly higher in group A when compared with group B (0.002). It was also higher in group E when compared with group B (p = 0.001), group C (p = 0.011) and group D (0.022). There was also statistical significant difference in the mean levels of insulin (p = 0.013) and insulin resistance (p = 0.028) among the five groups. Insulin resistance was significantly higher (p = 0.033) in group D when compared with group B. This study revealed that diabetic patients on metformin monotherapy have a better response to blood glucose monitoring when compared to other groups. Also, the highest level of insulin and insulin resistance were seen in diabetics on insulin monotherapy. There is need to monitor and control serum insulin and insulin resistance of diabetics on insulin therapy in order to enhance the efficacy of the therapy.

Keywords: Metformin, insulin; insulin resistance, type 2 diabetes mellitus