Effects of oral antidiabetic drugs over lipid parameters in Turkish type 2 diabetes patients


  • Penbe Cagatay Istanbul University Cerrahpasa Medical Faculty, Biostatistics Department, Aksaray-Istanbul
  • Belgin Susleyici-Duman Marmara University, Science and Art Faculty, Biology Department, Goztepe-Istanbul
  • Huriye Alasya Turkish Diabetes Hospital, Dr.Celal Oker Street. No.10 Harbiye-Istanbul
  • Ali Ipbuker Turkish Diabetes Hospital, Dr.Celal Oker Street. No.10 Harbiye-Istanbul


Type 2 diabetes, Sulphonylureas, Biguanides, Insulin and analogs, Serum lipids


Objective. We examined the effects of oral antidiabetics andinsulin/insulin analogs over lipid parameters for the firsttime in Turkish type 2 diabetic (T2DM) patients. Methods.A total of 312 T2DM subjects were included within 4 studygroups (sulphonylurea, biguanide, insulin/insulin analogs,sulphonylurea+biguanide) in this retrospective study. Thedemographic, biochemical and clinical data of the patientswere evaluated and the study groups were compared for allthe variables. The biochemical and lipid parameters were examinedin pairs for their correlations for each study group.Results. Body mass index (BMI) was found to be lower inthe insulin/insulin analogs group in comparison to the biguanideand sulphonylurea+biguanide groups (p < 0.01); systolicblood pressure (SBP) was found to be lower in the insulin/insulin analog group in comparison to the sulphonylurea,sulphonylurea+biguanide and biguanide groups (p < 0.05);diastolic blood pressure (DBP) was found to be lower in theinsulin/insulin analog group in comparison to the biguanidegroup (p<0.05). No difference was found for total-cholesterol,triglyceride, HDL-cholesterol and LDL-cholesterol amongthe study groups (p>0.05). Fasting blood glucose and HbA1clevels were found to be lower in the biguanide group whencompared to the sulphonylurea and insulin/insulin analogs(p<0.001). In all study groups a positive correlation wasfound between blood glucose and HbA1c levels (p<0.001). Aweak positive correlation was observed between blood glucoseand triglyceride (p<0.05) and HbA1c and LDL-cholesterol(p<0.05). Conclusion. Although no difference persistsbetween the treatment groups for total-cholesterol, triglycerides,HDL-cholesterol, and LDL-cholesterol, the insulin/insulinanalogs seem to lower serum lipids most effectively, whichmay help prevent coronary events in T2DM patients.


Download data is not yet available.


Pasaoğlu H, Sancak B, Bukan N. Lipid Peroxidation and Resistance to Oxidation in Patients with Type 2 Diabetes Mellitus. Thoku J Exp Med. 2004;203:211-8.

Onat A, Hergenc G, Uyarel H, Can G, Ozhan H. Prevalence, incidence, predictors and outcome of type 2 diabetes in Turkey. Anadolu Kardiyol Derg. 2006;6:314-21.

Gugliano D, Ceriello A, Paolisso G. Oxidative stress and diabetic vascular complications. Diabetes Care.1996;19:257-67.

Seghrouchni I, Drai J, Bannier E, Riviere J, Calmard P, Garcia I, et al. Oxidative stress parameters in type I, type II and insulin-treated type 2 diabetes mellitus; insulin treatment efficiency. Clin Chim Acta. 2002;321:89-96.

Lida KT, Kawakami Y, Suzuki M, Shimano H, Toyoshima H, Sone H, et al. Effect of thiazolidinediones and metformin on LDL oxidation and aortic endothelium relaxation in diabetic GK rats. Am J Physiol Endocrinol Metab. 2003;284:E1125-E1130.


Drouin P, Standl E; Diamicron MR Study Group. Gliclazide modified release: results of a 2-year study in patients with type 2 diabetes. Diabetes Obes Metab. 2004;6:414-21.

Antidiabetic drugs.http:/www.healthatoz.com/healthatoz/Atoz/common/ Standard/ transform.jsp? requestU…

Jarvinen H. Role of insülin resistance in the pathogenesis of NIDMM. Diabetologia. 1995;38:1378-88.

Dailey G, Rosenstock J, Moses RG, Kirk Ways. Insulin Glulisine Provides Improved Glycemic Control in Patients with Type 2 Diabetes. Diabetes Care. 2004;27:2363-8.

Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. Diabetes prevention program research group. N Engl J Med. 2002;346:393–403.

Sartor G, Scheniken B, Carlstrom S, et al. Ten year follow up of subjects with impaired glucose tolerance: prevention of diabetes by tolbutamide and diet regulation. Diabetes. 1980;29:41-9.

Stuart B, Shaffer TJ, Simoni-Wastila LJ, Zuckerman IH, Quinn CC. Variation in antidiabetic medication intensity among medicare beneficiaries with diabetes mellitus. Am J Geriatr Pharmacother. 2007;5:195-208.

Karlander SG, Gutniak MK, Efendi E. Effects of combination therapy with glyburide and insulin on serum lipid levels in NIDDM patients with secondary sulphonylurea failure Diabetes


Rodger W. Sulphonylureas and heart disease in diabetes management. Diabetes Spectrum. 1999;12:95–7.

Kabadi MU. Efficacy of sulphonylureas with insulin in type 2 diabetes mellitus. Ann Pharmacother. 2003;37:1572-6.

Drzewoski J, Czupryniak L, Chwatko G, Bald E. Total plasma homocysteine and insulin levels in type 2 diabetic patients with secondary failure to oral agents. Diabetes Care. 1999;22:2097-9.

Pasquali R, Gambineri A, Biscotti D, et al. Effect of long-term treatment with metformin added to hypocaloric diet on body composition, fat distribution, and androgen and insulin levels in abdominally obese women with and without the polycystic ovary syndrome. J Clin Endocrinol Metab. 2000;85:2767-74.

Kirpichnikov D, McFarlane SI, Sowers JR. Metformin: an update. Ann Intern Med. 2002;137:25-33.

DeWitt DE, Dugdale DC . Using new insulin strategies in the outpatient treatment of diabetes: clinical applications. JAMA. 2003;289:2265-9.

Jaber LA, Nowak SN, Slaughter RR. Insulin-metformin combination therapy in obese patients with type 2 diabetes. J Clin Pharmacol. 2002;42:89-94.

Wulffele MG, Kooy A, Lehert P, et al. Combination of insulin and metformin in the treatment of type 2 diabetes. Diabetes Care.2002;25:2133-40.

Wulffele MG, Kooy A, de Zeeuw D, et al. The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic review. J Intern Med. 2004;256:1-14.

Ginsberg H, Plutzky J, Sobel BE. A review of metabolic and cardiovascular effects of oral antidiabetic agents: beyond glucoselevel lowering. J Cardiovasc Risk. 1999;6:337-46.

Grant PJ. The effects of high- and medium-dose metformin therapy on cardiovascular risk factors in patients with type II diabetes. Diabetes Care. 1996;19:64-6.

Jarvinen H, Ryysy L, Nikkila K, et al. Comparison of bedtime insulin regimens in patients with type 2 diabetes mellitus. A randomized, controlled trial. Ann Intern Med. 1999;130:389-96.

Robinson AC, Burke J, Robinson S, et al. The effects of metformin on glycemic control and serum lipids in insulin-treated NIDDM patients with suboptimal metabolic control. Diabetes Care. 1998;21:701-5.

Groop L, Widen E, Franssila A, et al. Different effects of insulin and oral antidiabetic agents on glucose and energy metabolism in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1989;32:599-605.

Rains SG, Wilson GA, Richmond W, et al. The effect of glibenclamide and metformin on serum lipoproteins in type 2 diabetes. Diabet Med. 1988;5:653-8.

DeFronzo RA, Goodman AM. Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group. N Engl J Med. 1995;333:541-9.

Yamanouchi T, Sakai T, Igarashi K, Ichiyanagi K, Watanabe H, Kawasaki T.Comparison of metabolic effects of pioglitazone, metformin, and glimepiride over 1 year in Japanese patients with newly diagnosed Type 2 diabetes. Diabet Med. 2005;22:980-5.

Giugliano D, De Rosa N, Di Maro G, et al. Metformin improves glucose, lipid metabolism, and reduces blood pressure in hypertensive, obese women. Diabetes Care. 1993;16:1387-90.

Charles MA, Eschwege E, Grandmottet P, et al. Treatment with metformin of non- diabetic men with hypertension, hypertriglyceridaemia, and central fat distribution: the BIGPRO 1.2 trial. Diabetes Metab Res Rev. 2005;16:2-7.

Sartor G, Ursing D, Nilsson-Ehle P, et al. Lack of primary effect of sulphonylurea (glipizide) on plasma lipoproteins and insulin action in former type 2 diabetics with attenuated insulin action. Eur J Clin Pharmacol.1987;33:279-82.

Bergman M, Gidez LI, Eder HA. The effect of glipizide on HDL and HDL subclasses. Diabetes Res. 1986;3:245-8.

Pentikainen PJ, Voutilainen E, Aro A, et al. Cholesterol lowering effect of metformin in combined hyperlipidemia: placebo controlled double blind trial. Ann Med. 1990;22:307-12.

Carlsen SM, Rossvoll O, Bjerve KS, et al. Metformin improves blood lipid pattern in nondiabetic patients with coronary heart disease. J Intern Med. 1996;239:227-33.




How to Cite

Cagatay, P., Susleyici-Duman, B., Alasya, H., & Ipbuker, A. (2009). Effects of oral antidiabetic drugs over lipid parameters in Turkish type 2 diabetes patients. Acta Medica Academica, 38(2), 77–85. Retrieved from https://ama.ba/index.php/ama/article/view/65



Basic Science

Similar Articles

You may also start an advanced similarity search for this article.