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Date of Graduation

8-2001

Degree Type

Capstone Project (On-Campus Access Only)

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

William Hatch, MS, PA-C

Abstract

Objective To compare the effect of the following two agents, metformin and sulfonylureas, on hyperglycemia, dyslipidemia, and weight loss in type 2 diabetic patients and to determine which one should be used as the primary line of treatment for this disease. Design and Methods Two years retrospective chart review from May 1999 to June 2001 on patients with type 2 diabetes mellitus who's at the time of diagnosed body weight was> 120% of ideal body weight (IBW), fasting plasma glucose (FPO) > 126 mgldL, serum trigliceride (TO) > 220 mgldL, LDL > 120mgldL, HDL < 3SmgldL and HgbAIC > 8%. A total of 40 patients met these inclusion criteria. Twenty-five of them were started on second generation sulfonylurea of doctor's choice, 10 of the subjects were on a combination of sulfonylurea and metformin, and 5 of them on metformin alone. Setting Thirty-five participants were patients from La Clinica del Carino in Hood River, OR and the remainders 5 were from dr. Hector Rodriguez's practice in Portland, OR. Results Patients treated with metformin as monotherapy or combination therapy were able to maintain a better glycemic, lipemic and weight control when compared to sulfonylurea group alone. Of the S patients on metformin alone, 100% demonstrated a 3 to 4 percentage point reduction in HgbAlc, a mean 6SIbs weight loss, a mean reduction IS mg /dL in LDL, a mean reduction of SO mgldL in TO, and a mean increase of 9 mgldL in HDL, p < 0001. Conclusion The positive results of using metformin as a monotherapy or an adjunctive therapy on the management of type 2 diabetes mellitus patients was comparable to that reported on the largest, multicenter study in the United Kingdom, the UKPDS in which Metformin appeared to be the drug of choice in obese diabetic patients.

Comments

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