Anti oxidant potential of Metformin and Pioglitazone in Type 2 Diabetes Mellitus: Beyond their anti glycemic effect.
OBJECTIVE
Insulin sensitizers might influence oxidative stress to improve insulin resistance in diabetes mellitus. The present study was designed with the aim to study the effect of Metformin & Pioglitazone on markers of oxidative stress after 4 weeks of therapy in patients with type 2 diabetes mellitus (Type 2 DM).


METHODS
This was a prospective study with follow up of 4 weeks in patients with Type 2 DM. They were randomized into metformin treated group (N=20) and Pioglitazone treated group (N=20) and healthy age-matched control group (N=20). Data was presented as mean±S.D. Student "t" test, ANOVA and Pearson correlation co-efficient tests were performed to analyze the parametric data in this study.


RESULTS
Baseline clinical characteristics of the two study groups were similar. There is a significant difference for Fasting plasma glucose (FPG) and 2h-Post Prandial Plasma Glucose (PPPG) after 30 days of metformin and pioglitazone treatment. Metformin significantly reduced MDA (p=0.041) and increased SOD (p<0.001). Pioglitazone significantly reduced MDA (p<0.001) but failed to raise SOD level (p=0.132). Mean MDA was 4.57±0.57μM/L in metformin and 2.91±0.66μM/L in pioglitazone treatment with a p-value of <0.001. Further, a similar significant difference was obtained for SOD value by metformin and pioglitazone treatment (7.87±0.72U/ml vs. 6.94±0.53U/ml; p<0.001).


CONCLUSIONS
Pioglitazone was superior to Metformin to improve oxidative stress as reflected by reduction in MDA but the antioxidant effect i.e. increase in SOD was seen with metformin only. The differing mechanism of actions of the two drugs on oxidative stress favors co prescription of these drugs for better outcome in improving insulin resistance and diabetic complications.
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India.
R K
RK
Singh
Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India.
B
B
Gupta
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India.
K
K
Tripathi
Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India. Electronic address: sksendocrine@yahoo.com.
S K
SK
Singh
D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007333:Insulin Resistance; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008687:Metformin / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D000077205:Pioglitazone; D013482:Superoxide Dismutase / Q000378:metabolism; D045162:Thiazolidinediones / Q000494:pharmacology* / Q000627:therapeutic use
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D008315:Malondialdehyde; D008687:Metformin; D013482:Superoxide Dismutase; D000077205:Pioglitazone
Malondialdehyde (MDA); Metformin; Pioglitazone; Superoxide Dismutase (SOD); Type 2 Diabetes