Efficacy and safety of sulfonylurea drugs in the patients with type 2 diabetes mellitus in combination with coronary artery disease
AbstractObjective: to evaluate the efficacy and safety of the use of sulfonylurea drugs in patients with type 2 diabetes mellitus in combination with coronary artery disease.
Methods: All patients with stable coronary artery disease and type 2 diabetes mellitus, uncontrolled with metformin alone (HbA1c 7,6–9%), underwent routine clinical examination, laboratory and instrumental examinations, including clinical and biochemical analyzes of blood, determination of markers of oxidative stress, continuous glucose monitoring, 24 hours ECG monitoring with the assessment of heart rate variability and cardiac stress tests. In the second stage to improve the performance of carbohydrate metabolism main group randomized into 2 groups: metformin in combination with glibenclamide and metformin combined with gliclazide. The duration of treatment is 3 months. Later check-up is carried out by previous plan.
Results: We investigated 10 patients with type 2 diabetes and coronary artery disease (6 male / 4 female) from 47 to 68 years, mean age 55,1±6,7 years, the duration of type 2 diabetes from 0,6 to 1,7 years , CHD duration from 1 to 8 years. The initial level of glycated hemoglobin 8,03±0,43%. In the survey, 50% of patients have a lower total antioxidant activity of the serum, the data correspond to the CGMS decompensation of carbohydrate metabolism (mean duration of hyperglycemia during the day 68%), 60% of patients reduction of the spectral parameters of heart rate variability, exercise tolerance is the average. Currently, a second phase of the study. 50 % of the principal groups are taking metformin in combination with glibenclamide in the average daily dose of 3.5 mg / day and 50 % in combination with metformin, gliclazide in the average daily dose of 60 mg / day.
In the near future the completion of the second phase of the study with the formation of the final conclusions.
Keywords:type 2 diabetes mellitus, stable CHD, sulfonylurea drugs, continuous glucose monitoring, ECG monitoring, heart rate variability, oxidative stress