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Indian Journal of Clinical Biochemistry logoLink to Indian Journal of Clinical Biochemistry
. 2007 Sep;22(2):65–69. doi: 10.1007/BF02913316

A comparative study on the effects of diet and exercise, metformin and metformin+pioglitazone treatment on NIDDM patients

K T Augusti 1,✉, N P Sunil 1, Andrews Abraham 1, Sajimon Thomas 1, Varghese Chemmanam 3
PMCID: PMC3453793  PMID: 23105685

Abstract

A comparative study on two groups of newly diagnosed nonobese and obese NIDDM patients who were 15 in each group and treated by diet cum exercise and metfromin monotherapy respectively and a third group of 15 obese NIDDM patients whose hyperglycemia was not first controlled by a combination therapy of metformin and sulfonylurea and therefore changed over to a different combination therapy of metformin and ploglitazone, was carried out before and after a period of three months treatment. The mild hyperglycemia in the 1st group and the moderate or severe hyperglycemia with accompanied disorders of serum enzymes such as AST, ALT, GGT and the level of HBA10 observed with 2nd and 3rd groups of obese NIDDM patients were significantly ameliorated by the respective mode of treatments. Here the efficacies of the three types of treatment are substantiated and further it specifically depicts the success with the choice of combination therapy with metformin and pioglitazone in the third group of obese diabetics.

Key words: NIDDM patients, Diet cum exercise, Metformin, Pioglitazone, FBS, Enzymes, HbA10

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References

  • 1.Grundy SM. Dietary therapy in diabetes mellitus: Is their a single best diet? Diabetes Care. 1991;14:796–801. doi: 10.2337/diacare.14.9.796. [DOI] [PubMed] [Google Scholar]
  • 2.Pan X, Huy Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. Diabetes Care. 1997;20(4):537–44. doi: 10.2337/diacare.20.4.537. [DOI] [PubMed] [Google Scholar]
  • 3.Labovitz HE. Non-Insulin dependent (type II) diabetes mellitus. In: Krishna Berg RA., editor. Diabetes Mellitus. La Jolla, Calif: Publishers National Health Laboratory; 1992. pp. 16–25. [Google Scholar]
  • 4.Marshall JA, Hamman RF, Baxter J. High fat low carbohydrate diet and etiology of non-insulin dependent diabetes mellitus: The San Luis Valley Diabetes study. Am J Epidemiol. 1991;134:590–603. doi: 10.1093/oxfordjournals.aje.a116132. [DOI] [PubMed] [Google Scholar]
  • 5.Implications for reducing chronic disease risk. Washington DC: National Academy Press; 1989. [PubMed] [Google Scholar]
  • 6.Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS. Physical activity and reduced occurrence of Non-Insulin dependent diabetes mellitus. N Engl Med. 1991;325:147–52. doi: 10.1056/NEJM199107183250302. [DOI] [PubMed] [Google Scholar]
  • 7.Horton ES. Exercise and decreased risk of NIDDM. N Engl J Med. 1991;325:196–8. doi: 10.1056/NEJM199107183250308. [DOI] [PubMed] [Google Scholar]
  • 8.Pharmacology and Pharmacotherapeutics 13th edn by Satoskar RS, Bhandorkar SD. Chapter 60. P. 806. Insulin and Oral anti-diabetic drug.
  • 9.Bailey CJ. Biguanides and NIDDM. Diabetes Care. 1992;15:755–72. doi: 10.2337/diacare.15.6.755. [DOI] [PubMed] [Google Scholar]
  • 10.UK Prospective Diabetes Study group Effect of intensive blood glucose control with metformin on complications in overweight patients with type II diabetes. Lancet. 1998;352:854–66. doi: 10.1016/S0140-6736(05)61359-1. [DOI] [PubMed] [Google Scholar]
  • 11.Moses R, Slobodnuik R, Donnelly T. Additional treatment with repaglinide provides significant improvement in glycemic control in NIDDM patients poorly controlled on metformin (abstr.) Diabetes. 1997;46(suppl 1):93A–93A. [Google Scholar]
  • 12.Purnell JQ, Hirsch IB. New oral therapies for type 2 diabetes. Am Fam Physician. 1997;56:1835–42. [PubMed] [Google Scholar]
  • 13.Salral AR, Olesfasky J. Thiazolidine diones in the treatment of insulin resistance and type 2 diabetes. Diabetes. 1996;45(12):1661–69. doi: 10.2337/diabetes.45.12.1661. [DOI] [PubMed] [Google Scholar]
  • 14.Ertel NH. New therapeutic agents for type 2 diabetes: In managing type 2 diabetes. Postgraduate Medicine Special report. 1998;March:25–32. [Google Scholar]
  • 15.Olesfasky J, Ravazzalo M, Kailsaram Oral hypoglycemic agents in diabetic subject. Diabetes Care. 1976;14:312–28. [Google Scholar]
  • 16.Wootion I.D.P., editor. Microanalysis in Medical Biohemistry. 4th ed. London: J and A Churchill Ltd; 1964. pp. 96–96. [Google Scholar]
  • 17.Kampen EJ, Zijlstra W-G. Standardization of hemoglobinometry II. The hemiglobincyanide method. Clin. Chem Acta. 1961;6(4):538–44. doi: 10.1016/0009-8981(61)90145-0. [DOI] [PubMed] [Google Scholar]
  • 18.Bergmeyer HU. Standardization of Enzyme Assays. Clin Chem. 1972;18:1305–11. [PubMed] [Google Scholar]
  • 19.Horder M, Rej R. In: Alanine transaminase, in methods of enzymatic analysis. 3rd edn. Bergmeyer H., Bergmeyer J., Grassl M., editors. Basel: Weinheim Verlag Chemie; 1983. pp. 444–444. [Google Scholar]
  • 20.Kulhanik V, Dimov DM. A new useful modification for the determination of gamma-glutamyl transferase activity. Clin Chem Acta. 1966;14(5):619–23. doi: 10.1016/0009-8981(66)90186-0. [DOI] [PubMed] [Google Scholar]
  • 21.National Institute for Clinical Excellence: Guidance on the use of pioglitazone for type 2 diabetes mellitus. Technology appraisal guidance No. 21. March 2001.
  • 22.King AB. A comparison in a clinical setting of the three thiazolidine diones (letter) Diabetes care. 2000;23:557–557. doi: 10.2337/diacare.23.4.557b. [DOI] [PubMed] [Google Scholar]
  • 23.Aronoff S, Rosenblatt S, Braith WS, Egan JW, Mathisen AL, Schnieder RL. Pioglitazone hydrochloride monotherapy improves glycemic control in the treatment of patients with type 2 diabetes, a six months randomized placebo-controlled dose-response study group. The pioglitazone 001 study group. Diabetes Care. 2000;23:1605–11. doi: 10.2337/diacare.23.11.1605. [DOI] [PubMed] [Google Scholar]
  • 24.Tack C, Demacker P, Stairs P, Stalenhoef A. Trioglitazone decreases the proportion of small, dense LDL and increases the resistance of LDL to oxidation in obese subjects. Diabetes Care. 1998;21:796–9. doi: 10.2337/diacare.21.5.796. [DOI] [PubMed] [Google Scholar]
  • 25.Derosa G, Cicero AF, Gaddi A, Ragonesi PD, Fogari E, Bertone G, Cicarelli L, Piccinni MN. Metabolic effects of pioglitazone and rosiglitazone in patients with diabetes and metabolic syndrome treated with glimepiride: a Twelve month, multicenter, double-beind, randomized, cortrolled, parallel group trial. Clin Ther. 2004;26(5):744–54. doi: 10.1016/S0149-2918(04)90074-4. [DOI] [PubMed] [Google Scholar]
  • 26.Mattoo V, Eckland D, Widel M, Duarn S, Fajardo C, Strand J, et al. Metabolic effects of pioglitazone in combination with insulin in patients with type 2 diabetes mellitus whose disease is not adequately controlled with insulin therapy: results of six months randomized, double blind, prospective, multicentre, parallel group study. Clin Ther. 2005;27(5):554–67. doi: 10.1016/j.clinthera.2005.05.005. [DOI] [PubMed] [Google Scholar]

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