Difference of changes in total and triglyseride cholesterol levels of insulin monotherapy use with combination insulin and metformin therapy in type II diabetes mellitus patients
Backround: Diabetes mellitus (DM) is a degenerative disease predicted by WHO to increase in Indonesia from 8.4 million in 2000 to around 21.3 million in 2030. Diabetes mellitus is closely related to dyslipidemia which can increase the risk of coronary artery disease (CAD). Current DM treatment is using oral hypoglycemic drugs, insulin, or a combination of both. Many previous studies have not examined the effect of these therapies on lipid profiles, specifically total cholesterol and triglyceride levels.
Objective: To determine the differences in changes in total cholesterol and triglyceride levels between the use of insulin monotherapy and combination therapy of insulin and metformin in patients with type II diabetes mellitus in Sleman Yogyakarta Hospital from January 2010 toJune 2012.
Methods: This study was an observational analytic study using a retrospective cohort study method with samples (n = 64). Samples were taken by non-probability consecutive sampling, carried out in DM patients inpatient or outpatient at Sleman Yogyakarta Hospital for the period of January 2010 - June 2012. The samples were divided into two groups, insulin monotherapy group and insulin and metformin combination therapy group. The data taken was the total cholesterol and the first triglyceride level, then the second total cholesterol and triglyceride data were made after four months of getting therapy.
Result: Analysis of statistical data using the Mann Whitney test for changes in total cholesterol levels in the two treatment groups showed p = 0.166, whereas for changes in triglyceride levels in the two treatment groups it was found that p = 0.840.
Conclusion: There were no significant differences in changes in total cholesterol and triglyceride levels between the two treatment groups.
Sudoyo AW, Setiyohadi B, Alwi I, Setiati S, Al E. Ilmu penyakit dalam. V (3). Jakarta: Interna; 2009.
Perkumpulan Endokrinologi Indonesia (PERKENI). Konsensus pengendalian dan pencegahan diabetes mellitus tipe2 di Indonesia 2011. Jakarta; 2011.
Suyono S, Waspadji SW, Soegondo S, Soewondo P, et al. Penatalaksanaan diabetes melitus terpadu. Jakarta: Balai Penerbit FK UI; 2011.
Mooradian AD. Dyslipidemia in type 2 diabetes mellitus. Nature Clinical Practice Endocrinology & Metabolism. 2009;5:150–9.
Krauss MR. Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care Journal. 2004;27(6):1496–504.
Mourao-Junior CA, Sá JR, Guedes OMS, Dib SA. Effects of metformin on the glycemic control, lipid profile, and arterial blood pressure of type 2 diabetic patients with metabolic syndrome already on insulin. Brazillian Journal of Medical and Biological Research. 2006;39(4):489–94.
Strowig SM, Avilés-Santa ML, Raskin P. Comparison of insulin monotherapy and combination therapy with insulin and metformin or insulin and troglitazone in type 2 diabetes. Diabetes Care. 2002;25(10):1691–8.
Sherwood L. Human physiology?: From cells to system. 2nd ed. Nella Yesdelita, editor. Jakarta: EGC; 2001.
Brunton LL, Parker KL, Blumenthal KD, Buxton I. Goodman & Gilman manual farmakologi dan terapi. July M, editor. Jakarta: EGC; 2008.
Katzung BG. Basic & Clinical Pharmacology. 10th ed. Jakarta: EGC; 2007.
Tjokoprawiro A. Diabetes melitus klasifikasi, diagnosis, dan terapi. Jakarta: PT. Gramedia Pustaka Utama; 2001.
Riddle MC. Combined therapy with insulin plus oral agents?: Is there any advantage? Diabetes Care. 2008;31(Supplement 2):125–30.
Sinorita H. Diabetes melitus dan dislipidemia. In: Seminar Nasional 2007 Clinical Updates. Bagian Ilmu Penyakit Dalam Fakultas Kedokteran UGM/RSUP Sardjito; 2007. p. 29–36.
Syarif A, Esuningtyas A, Setiyawati A, Muchtar A. Farmakologi dan terapi. 5th ed. Jakarta: Balai Penerbit FKUI; 2009.