Research Article
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Glimeprid ve Gliklazid Kullanan Diyabetik Hastalarda Metabolik Bulguların Değerlendirilmesi

Year 2015, Volume: 12 Issue: 2, 185 - 192, 30.08.2015

Abstract

Amaç: Diyabetes Mellitus (DM) çeşitli klinik ve biyokimyasal bulgularla seyreden, birçok sistemi
etkileyebilen kronik bir metabolizma hastalığıdır. Tip 2 diyabet, tüm vakaların %80-90'ını oluşturur. Tip 2
DM tedavisinde çeşitli oral antidiyabetik (OAD) ilaçlar kullanılır. Bu çalışmada, ikinci jenerasyon
sülfonilüre grubundan olan gliklazid ve glimepirid kullanan hasta gruplarının kendi içinde ve birbirleri
arasındaki metabolik kontrol parametrelerini karşılaştırmayı amaçladık.
Metod: Bu çalışma; Şişli Etfal Eğitim ve Araştırma Hastane'sinde 2007-2008 tarihleri arasında tip 2 DM
tanılı 184 hasta üzerinde retrospektif olarak yapıldı. Hastalar gliklazid ve glimepirid kullanımlarına göre
ayrıldı. Yaş, cinsiyetleri kaydedildi ve insülin-ek oral antidiyabetik kullanıp kullanmadıkları soruldu. Üç ay
arayla hastalar iki kez değerlendirildi. Her iki değerlendirmede de kilo, vücut kitle indeksi, açlık kan glukozu
(AKG), HbA1c düzeyi, lipid profili, arteryel kan basıncı, 24 saatlik idrarda mikroalbüminüri düzeyine
bakıldı, hipoglisemi öyküsü sorgulanarak kaydedildi.
Bulgular: AKG ortalamasında istenilen hedeflere her iki grup içinde ulaşılamadı. Her iki grupta da 3. ayın
sonunda ADA (American Diyabetes Association)'nın belirlediği %7.0'lık HbA1C düzeyine ulaşıldı.
Karşılaştırılan diğer metabolik kontrol parametreleri arasında her iki grup arasında anlamlı farklılık
saptanmadı.
Sonuç: Bu çalışmada gliklazid kullanan grupta 3 aylık takip sonunda AKG ortalaması açısından istatistiksel
olarak anlamlı düşme saptanmış olsa da istenilen hedeflere sayıca az olan glimepirid kullanan grup gibi
ulaşılamamış gözükmektedir. Glimepirid kullanan grupta 3 aylık takip sonunda HbA1c ortalaması
açısından gliklazid grubunun aksine istatistiksel olarak anlamlı düşme saptanmasa da istenilen HbA1C
hedefine ulaşılmış gözükmektedir. Sonuç olarak tip 2 DM tedavisinde her iki ilacın da OAD olarak
birbirlerine üstünlüklerinin olmadığı sonucuna varıldı.

References

  • 1. Uncu Y, Ersun HG. Aile Hekimliğinde Diabetes Mellitus'a Yaklaşım. In: Bilgel N (ed). Aile Hekimliği, 1.Baskı, Ankara: Medikal Tıp Kitabevi, 2006:479-497
  • 2. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Research and Clinical Practice 2010;87:4-14
  • 3.International Diabetes Federation. Diabetes Atlas. 6th edition, 2013. http://www.idf.org/diabetesatlas4. Satman İ. TURDEPII Çalışması ilk sonuçlar, 32.TEMH Kongresi, 13-17 Ekim 2010, Antalya. Kongre Kitabı, 2010:12
  • 5.American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care.2014;37 Suppl 1:S14-80.
  • 6. Inzucchi, S.E.,2002. Oral atihyperglycemic therapy for type 2 diabetes: Scientific review. JAMA. 287, 360- 372
  • 7. Levetan, C., 2007. Oral antidiabetic agents in type 2 diabetes. Curr. Med. Res. Opin. 23, 945-952
  • 8. Koski RR. Practical review of oral antihyperglycemic agents for type 2 diabetes mellitus. Diabetes Educ. 2006;32(6):869-876.
  • 9. Çorakçı A, Azal Ö, Beyhan Z, 2009. Diabetes Mellitus'ta Oral Ajan Tedavisi, in Diabetes Mellitus 2009 Mutidisipliner Yaklaşımla Tanı, Tedavi ve İzlem, Vol 9, İmamoğlu Ş, Ersoy Özyardımcı C eds, Deomed, İstanbul, 137-176
  • 10. Inzucchi SE, Bergenstal RM, Buse JB, et al. American Diabetes Association; Management of Hyperglycemia in Type2 Diabetes: A Patient- Centered Approach, Diabet Care 2012;35:1364-1379
  • 11. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014;37 Suppl 1:S14-80.
  • 12. Satman İ, İmamoğlu Ş, Yılmaz C, Akalın S, Salman S,TEMD Diabetes Mellitus Calışma Grubu. TEMD Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu. Bayt Bilimsel Araştırmalar Basın Yayın Tanıtım Ltd. Şti. Ankara, 2014
  • 13. Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, Dagogo-Jack S, Davidson MB, Einhorn D, Garvey WT, Grunberger G, Handelsman Y, Hirsch IB, Jellinger PS, McGill JB, Mechanick JI, Rosenblit PD, Umpierrez G, Davidson MH; American Association of Clinical Endocrinologists. AACE comprehensive diabetes management algorithm 2013. Endocr Pract. 2013;19(2):327-336.
  • 14. Onat A. Türk erişkinlerinde diyabet ve prediyabet: patogeneze önemli Katkı. TEKHARF 2009. 2. Baskı. Figür Grafik ve Matbaacılık Tic. Ltd. Şti., İstanbul. 2009, 140-146.
  • 15. Banegas JR, López-García E, Dallongeville J, Guallar E, Halcox JP, Borghi C, et al. Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study. Eur Heart J 2011;32:2143-52.
  • 16. Tokgözoğlu L, Kaya, EB, Erol C, Ergene O; EUROASPIRE III Turkey Study Group. EUROASPIRE III: a comparison between Turkey and Europe. [Article in Turkish] Türk Kardiyol Dern Arş 2010;38:164-72.
  • 17. Chobanian AV, Bakris GL, Black HR, et al: The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA2003:289:2560-2572
  • 18. World Health Organization, Department of Noncommunicable Disease Surveillance. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Report of a WHO Consultation, WHO Publ., Geneva, 1999
  • 19. Brownlee M, Aiello LP, Cooper ME. Complications of Diabetes Mellitus. In: Kronenberg HM, Melmed S, Polonosky KS, Larsen PR (eds). Williams Textbook of Endocrinology. 11th ed. Philedelpia, Saunders Elsevier, 2008 p. 1478-83

Evaluation of Metabolic Findings in Diabetic Patients Using Glimepiride and Gliclazide

Year 2015, Volume: 12 Issue: 2, 185 - 192, 30.08.2015

Abstract

Backgrounds: Diabetes mellitus which proceeds with various clinical and biochemical symptoms is a
chronic metabolic disease that can affect many sistems. Types 2 diabetes constitute 80 to 90% of all cases.
Various oral antidiabetic drugs can be used in the treatment of type 2 diabetes. In this study, two patients'
groups using glimepiride and gliclazide which are from second generation sulfonylurea group were included
and metabolic parameters were compared within and between the groups.
Methods: This study is conducted on 184 patients who were diagnosed Types 2 diabetes mellitus in Şişli
Etfal education and reseach hospital between 2007-2008. Patients were seperated according to usage of
gliclazide or glimepride. Ages and genders of the patients were viewed. Taking insülin and taking oral
antidiabetic with insulin were asked. Patients were evaluated twice in three months period. Body
weight,body mass index, fasting blood glucose, HBA1c levels, lipid profile, arterial blood pressure, the 24
hour urine levels of microaluminuria were analyzed in both of the evaluations, a history of hypoglycemia
were also noted.
Results: The desired goals in average fasting blood glucose can not be reached in both of the groups. After
three months the level of 7.0% HBA1C, determined by the ADA criteria, has been reached in the groups.
There were no significant differences between the two groups according to the other metabolic control
parameters.
Conclusions: In this study, it is understood that the effects of taking glimeprid or gliclazid to the regulation of
blood glucose are similar, and at the end of the 3-months follow up, there is no difference between the two
groups in achieving the desired target of HBA1C. It is appeared that both of the drugs have no any dominance
as an oral antidiabetic in the treatment of the type 2 DM to each other. 

References

  • 1. Uncu Y, Ersun HG. Aile Hekimliğinde Diabetes Mellitus'a Yaklaşım. In: Bilgel N (ed). Aile Hekimliği, 1.Baskı, Ankara: Medikal Tıp Kitabevi, 2006:479-497
  • 2. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Research and Clinical Practice 2010;87:4-14
  • 3.International Diabetes Federation. Diabetes Atlas. 6th edition, 2013. http://www.idf.org/diabetesatlas4. Satman İ. TURDEPII Çalışması ilk sonuçlar, 32.TEMH Kongresi, 13-17 Ekim 2010, Antalya. Kongre Kitabı, 2010:12
  • 5.American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care.2014;37 Suppl 1:S14-80.
  • 6. Inzucchi, S.E.,2002. Oral atihyperglycemic therapy for type 2 diabetes: Scientific review. JAMA. 287, 360- 372
  • 7. Levetan, C., 2007. Oral antidiabetic agents in type 2 diabetes. Curr. Med. Res. Opin. 23, 945-952
  • 8. Koski RR. Practical review of oral antihyperglycemic agents for type 2 diabetes mellitus. Diabetes Educ. 2006;32(6):869-876.
  • 9. Çorakçı A, Azal Ö, Beyhan Z, 2009. Diabetes Mellitus'ta Oral Ajan Tedavisi, in Diabetes Mellitus 2009 Mutidisipliner Yaklaşımla Tanı, Tedavi ve İzlem, Vol 9, İmamoğlu Ş, Ersoy Özyardımcı C eds, Deomed, İstanbul, 137-176
  • 10. Inzucchi SE, Bergenstal RM, Buse JB, et al. American Diabetes Association; Management of Hyperglycemia in Type2 Diabetes: A Patient- Centered Approach, Diabet Care 2012;35:1364-1379
  • 11. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014;37 Suppl 1:S14-80.
  • 12. Satman İ, İmamoğlu Ş, Yılmaz C, Akalın S, Salman S,TEMD Diabetes Mellitus Calışma Grubu. TEMD Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu. Bayt Bilimsel Araştırmalar Basın Yayın Tanıtım Ltd. Şti. Ankara, 2014
  • 13. Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, Dagogo-Jack S, Davidson MB, Einhorn D, Garvey WT, Grunberger G, Handelsman Y, Hirsch IB, Jellinger PS, McGill JB, Mechanick JI, Rosenblit PD, Umpierrez G, Davidson MH; American Association of Clinical Endocrinologists. AACE comprehensive diabetes management algorithm 2013. Endocr Pract. 2013;19(2):327-336.
  • 14. Onat A. Türk erişkinlerinde diyabet ve prediyabet: patogeneze önemli Katkı. TEKHARF 2009. 2. Baskı. Figür Grafik ve Matbaacılık Tic. Ltd. Şti., İstanbul. 2009, 140-146.
  • 15. Banegas JR, López-García E, Dallongeville J, Guallar E, Halcox JP, Borghi C, et al. Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study. Eur Heart J 2011;32:2143-52.
  • 16. Tokgözoğlu L, Kaya, EB, Erol C, Ergene O; EUROASPIRE III Turkey Study Group. EUROASPIRE III: a comparison between Turkey and Europe. [Article in Turkish] Türk Kardiyol Dern Arş 2010;38:164-72.
  • 17. Chobanian AV, Bakris GL, Black HR, et al: The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA2003:289:2560-2572
  • 18. World Health Organization, Department of Noncommunicable Disease Surveillance. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Report of a WHO Consultation, WHO Publ., Geneva, 1999
  • 19. Brownlee M, Aiello LP, Cooper ME. Complications of Diabetes Mellitus. In: Kronenberg HM, Melmed S, Polonosky KS, Larsen PR (eds). Williams Textbook of Endocrinology. 11th ed. Philedelpia, Saunders Elsevier, 2008 p. 1478-83
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Gülseren Oktay

Muhammet Oktay This is me

Publication Date August 30, 2015
Submission Date August 13, 2013
Acceptance Date March 25, 2015
Published in Issue Year 2015 Volume: 12 Issue: 2

Cite

Vancouver Oktay G, Oktay M. Glimeprid ve Gliklazid Kullanan Diyabetik Hastalarda Metabolik Bulguların Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2015;12(2):185-92.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty