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The Effect Of Antidiabetic Agent Glibenclamide And Meltformine On Lipids And Glycated Haemoglobin In Type 2 Diabetes Patient Attending Uith Ilorin
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2.3 Environmental factors in the pathogenesis of type 2 diabetes
Aging, obesity, insufficient energy consumption, alcohol drinking, smoking, etc are independent risk factors of pathogenesis of type 2 diabetes. Obesity (particularly visceral fat obesity) due to a lack of exercise is accompanied by a decrease in muscle mass, induces insulin resistance, and is closely associated with the rapid increase in the number of middle and high aged patients. The changes in dietary energy sources, particularly the increase in fat intake, the decrease in starch intake, the increase in the consumption of simple sugars, and the decrease in dietary fiber intake, contribute to obesity and cause deterioration of glucose tolerance. Even mild obesity (Body mass index (BMI) < 25) causes a 4 to 5 fold increase in risk of developing diabetes, if accompanied by the increase in visceral fat mass. People prone to visceral fat accumulation due to hyperalimentation, and risk factors for diabetes are linked to the accumulation of visceral fat and the factors causing visceral fats. These include;
1. Stress- Related Factors
a. Overeating, especially excessive intake of simple sugars
b. Smoking
c. Increase in alcohol intake
d. Disorders of nervous and endocrine systems: increase in cortisol, abnormality in sex hormone secretion
2. Lowered energy consumption due to a lack of exercise
3. Genetic factors
4. Aging
Source: (Kaku, 2010).
2.3 Pathophysiology of type 2 diabetes (NIDDM)
Individuals with NIDDM have detectable levels of circulating insulin, unlike patients with IDDM. On the basis of oral glucose tolerance testing the essential elements of NIDDM can be divided into four distinct groups:
i. Those with normal glucose tolerance.
ii. Chemical diabetes (called impaired glucose tolerance).
iii. Diabetes with minimal fasting hyperglycemia (fasting plasma glucose less than 140 mg/dl).
iv. Diabetes mellitus in association with overt fasting hyperglycemia (fasting plasma glucose greater than 140 mg/dl).
The individuals with impaired glucose tolerance have hyperglycemia inspite of having highest levels of plasma insulin, indicating that they are resistant to the action of insulin. In the progression from impaired glucose tolerance to Diabetes mellitus, the level of insulin declines indicating that patients with NIDDM have decreased insulin secretion. Insulin resistance and insulin deficiency are common in the average NIDDM patients (Holt, 2004). Insulin resistance is the primary cause of NIDDM, however some researcher contend that insulin deficiency is the primary cause because a moderate degree of insulin resistance is not sufficient to cause NIDDM (Raju and Raju, 2010). Most patients with the common form of NIDDM have both defects. Recent evidence has demonstrated a role for a member of the nuclear hormone receptor super family of proteins in the etiology of type 2 diabetes (Raju and Raju, 2010). Relatively new classes of drugs used to increase the sensitivity of the body to insulin are the thiazolidinedione drugs. These compounds bind to and alter the function of the peroxisome proliferators-activated receptor g (PPARg). PPARg is also a transcription factor and when activated, binds to another transcription factor known as the retinoid x receptor (RXR). When these two proteins are complexed a specific set of genes becomes activated. PPARg is a key regulator of adipocyte differentiation; it can induce the differentiation of fibroblasts or other undifferentiated cells into mature fat cells. PPARg is also involved in the synthesis of biologically active compounds from vascular endothelial cells and immune cells (Raju and Raju, 2010).
2.4 LIPIDS
Lipids are a group of naturally occurring molecules that include fats, waxes, sterols, fat soluble vitamins (such as vitamin A, D, E and K), monoglycerides, diglycerides, triglycerides, phospholipids and others. The main biological functions of lipids include storing energy, signaling, and acting as structural components of cell membranes. Lipids have applications in the cosmetic and food industries as well as in nanotechnology (Mashaghi et al., 2013).
Lipid is a fat-like molecule. It is chemically defined as a substance that is insoluble in water and soluble in alcohol, ether and chloroform. Lipids are an important component of living cells together with carbohydrate and protein. Lipids are the main constituent of plant and animal cells. Cholesterol and triglycerides are lipids (Spener et al., 2009).
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ABSRACT - [ Total Page(s): 1 ]Abstract Is Coming Soon ... Continue reading---
APPENDIX A - [ Total Page(s): 1 ]APPENDIX IQUESTIONAIRE TO ACCESS THE ANTHROPOLOGIC INDICES OF PATIENTS WITH TYPE TWO DIABETES MELLITUS ON ANTIDIABETIC DRUGS (METFORMIN AND GLIBENCLAMIDE) ATTENDING UITH ILORIN.INTRODUCTION: I am a final year students of the Department of Medical Laboratory Science, School of Basic Medical Sciences, Kwara State University, Malete, Kwara State. This questionnaire is aimed at accessing the demographic indices of patients with type 2 Diabetes mellitus on metformin and diabinese in Ilorin metropolis ... Continue reading---
APPENDIX B - [ Total Page(s): 5 ]Step 2100µl of the supernatant was dispensed into the clean test tubes respectively.2ml of the cholesterol reagent was addedIt was incubated at room temperature for 10minsAbsorbance of sample against reagent blank was measured at 505nmGlycated HaemoglobinGlycated Haemoglobin is a form of haemoglobin that is measured primarily to identify the three-month average plasma glucose concentration. The test is limited to a three-month average.ProcedureReagentsBlank(µl) samp ... Continue reading---
CHAPTER ONE - [ Total Page(s): 2 ]The present study was designed to investigate and compare the effects of glibenclamide and metformin on prevalence of metabolic syndrome in type 2 diabetic patients.1.2 STATEMENT OF PROBLEMTo know if antidiabetic agents glibenclamide and meltformine has any effect on lipid and glycated haemoglobin in type 2 diabetes patients1.3 AIM OF STUDYTo evaluate the effect of antidiabetic agent glibenclamide and meltformine on lipids and glycated haemoglobin in type 2 diabetes patient attendi ... Continue reading---
CHAPTER THREE - [ Total Page(s): 1 ]CHAPTER THREE3.1 Material and Method3.2 Study AreaThe study was carried out at University of Ilorin Teaching Hospital, Ilorin, Kwara State. The hospital is located at the State capital of Ilorin, Kwara State Nigeria. It is a referral center to other public and private hospitals within and outside the state.3.3 SAMPLE SIZE DETERMINATIONThere was a random selection of ninety (90) subjects, 60 were type 2 Diabetes mellitus individual using either one or combine antidiabetic agent (glibe ... Continue reading---
CHAPTER FOUR - [ Total Page(s): 4 ]Tables 4.6: Correlation of Duration in Diabetes and BMI with biochemical parameters (T. cholesterol, High Density Lipoprotein, Low Density Lipoprotein, triglycerides, glycated, and fasting blood sugar) in Diabetic patient using antidiabetic drugs (Metformin and Glianpride). ... Continue reading---
CHAPTER FIVE - [ Total Page(s): 2 ]CHAPTER FIVE5.0 DISCUSSIONThe study shows discrepant results about the influence of metformin on lipid profile (10). Some studies, in agreement with ours, reported reduction only in TC levels (Grant, 1996; Ginsberg et al., 1999), while others reported reduction of TC and TG with an increase of HDL-C (Robinson et al., 1998; Yki-Jarvinen et al., 1999). Still other studies showed no changes in lipid profile (Groop et al., 1998; Rains et al., 1998). Another investigation showed an association of met ... Continue reading---
REFRENCES - [ Total Page(s): 3 ]Rodger, W. (2012). Sulphonylureas and heart disease in diabetes management. Diabetes Spectrum. Pg. 12–27.Rosenbaum, M. and Leibel, R. L. (2014). Role of leptin in energy homeostasis in humans. Journal of Endocrinology. 223(1): 83-96.Rowley, D.E. and Bezold, D.C. (2012). Using new insulin strategies in the outpatient treatment of diabetes: clinical applications. Journal of American Medical Association. Pg. 289.Shaw, D., De Rosa, N. and Di Maro, G. (2010). Metformin improves glucose, lipid ... Continue reading---
