Study of glycemic response of oral anti-diabetic drugs in type 2 diabetic patients

Background: Type 2 Diabetes Mellitus (T2DM) is one of the most common non-communicable diseases associated with short term and long term avoidable complications. The treatment of T2DM often is initiated with monotherapy of oral antidiabetic drugs, which often do not decrease the plasma sugar levels effectively and consistently that will reduce the complications associated with T2DM. Hence the current study is aimed to determine the effectiveness of commonly available and affordable oral anti-diabetic drugs (OADs) in type 2 diabetic patients.Methods: This study consisted of 210 T2 Diabetic patients, 120 males and 90 females with a mean age of 50.93yrs were divided equally into six groups with equal number of males and females in each group depending upon the OADs they received in solo or in combination for 24weeks. After the written consent, a detail Clinical history, Clinical examination, Biochemical investigations including, Fasting plasma sugar (FPS), Post prandial sugar (PPS), Glycosylated heamoglobin (HBA1c), serum Creatinine, serum Electrolytes, Chest X-ray PA view and standard ECG were done. Repeat FPS, PPS and HBA1c were done after 4, 12 and 24weeks of study.Results: After 4 weeks, FPS, PPS decreased significantly in combination therapy (p <0.05), while after 12weeks and 24weeks of study, FPS, PPS and HBA1c decreased significantly (p <0.01 to p <0.001 in both monotherapy and in combination therapy. Non-diabetic levels of plasma sugars were obtained in 25-45% with monotherapy and 37-57% in combination therapy. Metformin was an effective monotherapy to initiate treatment of T2DM, but eventually combination therapy was required in most of the patients. The combinations of metformin-teneligliptin and metformin-glimepiride were found to be most effective because of their favourable pharmacokinetic characters and complementary pharmcodynamic effects.Conclusions: OADs are affordable, effective hypoglycemic agents to initiate treatment as monotherapy and for subsequent treatment as combination therapy for T2DM.