Comparison and Evaluation of Oral Hypoglycemic Drugs Combination Therapy for Control of T2DM

Abstract

Oral hypoglycemic drug therapy has successfully been used for controlling type-2 Diabetes Mellitus. Several new OHGs are flooding into the market and are prescribed to the patientsde pending upon effect and patient compliance, but no accurate combination of drugs has either been established or being customized that can exactly adapt to the biological system of patents. Since physical parameter differs from person-to-person, a comprehensive analysis is required to determine the right combination of OHGs. The current study aims towards a survey based analysis of OHG therapy in T2DM patients to observe the glycemic control through measurement of FBS, PPBS and HbA1c at specific time intervals. Briefly, 15 T2DM patients were observed longitudinally over 6 months for their glycemic control in response to different combination/mono OHG therapy. It was hypothesized that combination therapy of Biguanides(i.e Metformin) with other OHDs should give the best therapeutic benefits. For this subjects were selected within the Institutional community and the nearby locality. They were divided into three groups as per the OHG therapy (Group 1: Biguanide only; Group 2 Thiazolidinedion+Biguanide +Sulfonolyrea; and Group 3: Dipeptidyl Peptides’ -4 inhibitor+Sulfonolyrea). With informed consent, they were instructed to respond to a prepared Questionnaire involving diabetic history along with medical concerns like any complication of vital organs and limbs. The glycemic control was evaluated from FBS, PPBS and HbA1c measurements. Survey was conducted in 2 phases with a gap duration of 6 months. Data was obtained and statistical analysis was done.Subject variation was calculated by ANOVA. Paired –t test was carried out to derive the response difference at two time points (p ≤ 0.05) among three groups. Single factor ANOVA test was done. The results showed that Gr-I with Biguanides got significant therapeuric benefit over 6 months as obtained from FBS (p = 0.009) and HbA1c (p = 0.01). It also conclude that in starting phase of OHGs, Biguanide monotherapy has the best therapeutic benefit over the combination therapies.