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Impact of Gliclazide Modified Release or Glimepiride as Add-on Therapy to Metformin on Glycemic and Oxidative Stress Parameters in Type 2 Diabetic Patients
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Background: Type 2 diabetes mellitus is a condition characterized by an elevation of oxidative stress, which has been implicated in diabetic progression and its vascular complications. Aim: Assessing the impact of gliclazide modified release (MR) versus glimepiride on oxidative stress markers, glycemic indices, lipid profile, and estimated glomerular filtration rate in uncontrolled type 2 diabetic patients on metformin monotherapy. Methods: This was an observational comparative study conducted in Thi-Qar specialized diabetic, endocrine, and metabolism center. Sixty-six patients were randomized into two groups based on the addition of the sulfonylureas (SUs). Group 1 (33 patients) was on gliclazide MR, whereas Group 2 (33 patients) was on glimepiride. The measured oxidative stress markers were reduced glutathione (GSH), superoxide dismutase (SOD), malondialdehyde (MDA), and protein carbonyl (PC) evaluated before and after 16 weeks of SUs addition.   Results: There were significant drops in SOD (P < 0.001), MDA (P < 0.001), and PC (P = 0.001) and a significant increase in GSH (p = 0.029) levels after gliclazide MR add-on therapy. There were significant drops in SOD (P = 0.026) and MDA (P < 0.001) levels with non-significant changes in both GSH (P = 0.214) and PC (P = 0.538) after glimepiride add-on therapy. There was a significant difference in improvement of PC level (P = 0.048) in the gliclazide group compared to the glimepiride group, with a non-significant numerically higher improvement of GSH, SOD, and MDA in gliclazide MR than glimepiride. At the end of the study, there were no significant differences in glycemic control, lipid profile, or eGFR improvement between the two groups. Conclusion: Glycemic control plays a pivotal role in decreasing oxidative stress. The control of diabetes with the gliclazide-MR-metformin combination reduced oxidative stress more than the glimepiride-metformin combination, indicating its antioxidant property. Keywords: Oxidative Stress, T2DM, Gliclazide MR, Glimepiride, Metformin.    

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Publication Date
Sun Apr 20 2025
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Evaluation of Irisin Level in Iraqi Patients with Type 2 Diabetes and Pre-Diabetes Status as a Predictive Factor
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      The prevalence of diabetes is increasing rapidly and is now recognized as a significant global health problem. Diabetes occurs when a person does not produce enough insulin due to an imbalance in insulin production. This can lead to the failure of organs and tissues such as the kidneys, heart, blood vessels, eyes, nerves, and kidneys. As a result, early diagnosis and classification of type 2 diabetes mellitus (T2DM) are critical to aiding physician assessments. Subsequently, the current study aims to determine irisin levels in patients with T2DM and pre-DM as early predictors for disease cases. The current study included 138 subjects divided into three groups based on fasting blood glucose (FBG) and glycosylated hemoglobi

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Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
The Role of Metformin in patients with Primary Hypothyroidism
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Background: Insulin resistance is present in 50% or more of patients with primary hypothyroidism. Metformin can decrease TSH levels in these patients by a complex matter, this can be of great help in clinical practice.

Objective: This study was designed to evaluate the effect of metformin in reducing TSH levels in patients with primary hypothyroidism.

Methods: Hundred patients with primary hypothyroidism, 82 females, 18 males were included in this study, everyone was followed up for two months after adding metformin 850 mg twice daily in addition to thyroxin.

Results: 36 patients (36%) have a normal baseline TSH and no change after 2 months, 64 pa

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Publication Date
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
Lemon juice antioxidant activity against oxidative stress
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This study is conducted to evaluate the therapeutic and antioxidant effect of lemon juice on some hematological and biochemical parameters. Thirty female mice used in this study were exposed to oxidative stress through giving them hydrogen peroxide in drinking water for 30 days. Animals randomly distributed over 3 groups, each group contained 10 animals and treated as follows: T1 control group (drinking distilled water only), T2 (0.75% hydrogen peroxide in drinking water) and T3 (0.75% hydrogen peroxide in drinking water with daily drenching with 1 mL lemon juice). At the end of the experiment, blood samples were collected from animals for evaluating the following hematological and biochemical parameters: Haemoglobin concentration (Hb),

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Investigating the Effect of Genetic Polymorphisms of Deiodinase Type 2 on Levothyroxine Dose Requirements in Patients with Hypothyroidism
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Background: Hypothyroidism is the most abundant thyroid disorder worldwide. For decades, levothyroxine was the main effective pharmacological treatment for hypothyroidism. A variety of factors can influence levothyroxine dose, such as genetic variations. Studying the impact of genetic polymorphisms on the administration of medications was risen remarkably. Different genetic variations were investigated that might affect levothyroxine dose requirements, especially the deiodinase enzymes.  Deiodinase type 2 genetic polymorphisms’ impact on levothyroxine dose was studied in different populations. Objective: To examine the association of the two single nucleotide polymorphism (SNP)s of deiodinase type 2 (rs225013 and rs225014) and le

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Investigating the Effect of Genetic Polymorphisms of Deiodinase Type 2 on Levothyroxine Dose Requirements in Patients with Hypothyroidism
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Background: Hypothyroidism is the most abundant thyroid disorder worldwide. For decades, levothyroxine was the main effective pharmacological treatment for hypothyroidism. A variety of factors can influence levothyroxine dose, such as genetic variations. Studying the impact of genetic polymorphisms on the administration of medications was risen remarkably. Different genetic variations were investigated that might affect levothyroxine dose requirements, especially the deiodinase enzymes.  Deiodinase type 2 genetic polymorphisms’ impact on levothyroxine dose was studied in different populations.

Objective: To examine the association of the two single nucleotide polymorphism (SNP)s of deiodinase t

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Levels of Some Proinflammatory Cytokines in Obese Women with Polycystic Ovary Syndrome after Metformin Therapy
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Background: Polycystic ovary syndrome is a heterogeneous disorder and its etiology appears to be complex and multifactorial; characterized by hyperandrogenism, chronic anovulation and infertility. It’s associated with evidence of low-grade chronic inflammation, as indicated by the presence of elevated levels of high sensitive C- reactive protein levels, interleukin-6 and tumor necrosis factor-α. The source of excess circulating tumor necrosis factor-α in obese Polycystic ovary syndrome patient is likely to be the adipose tissues while in lean women increased visceral adiposity has been proposed as a source of excess tumor necrosis factor-α.Objectives: to evaluate the levels of high sensitive C- reactive protein, tumor necrosis facto

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Study Oxidative Stress Statues In Hypertension Women
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The oxidative stress is result of unbalancing between oxidants and antioxidants in the body. Hypertension (HT) is a measure of average systolic blood pressure which created by the heart contracting, greater ?140 mmHg or an average diastolic blood pressure, which is the heart fills, of ?equal to 90 mmHg. The study is conducted on 28 female patients with HT from Ibn Al-nafese hospital in addition to 28 female control. The markers measured are albumin, malondialdehyde (MDA) and 8-Hydroxy deoxyguanosine (8-OHdG). Also electrophoresis study on extracted DNA with Fenton reaction was done. Results of this study show there are high significant decrease (p?0.01) in albumin concentration of patient related to control, and there is a high significan

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Low dose tadalafil effect on anthropometric and metabolic parameters in Iraqi diabetic obese men
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Background: Phosphodiesterase-5 (PDE-5) inhibitorsrestore nitric oxide (NO) signaling and may reducecirculating inflammatory markers, and improve metabolicparameters through a number of mechanisms. Dailyadministration of the PDE-5 inhibitor, tadalafil (TAD) mayattenuate inflammation; improve fasting plasma glucose andtriglyceride levels and body weight. This study aims toevaluate the efficacy of low dose PDE-5 inhibitor, tadalafil(TAD) in controlling dysglycemia and body weight in obesediabetic men.Methods: Forty obese men with type 2 diabetes aged 30-50years incorporated in this study, all with A1c of 7-8.5%,attending obesity unit in AL-Kindy college of medicine.Weight, height, BMI, FPG, A1c, cholesterol, TG, HDL andLDL measured for all

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Long Term use of Glibenclamide on Serum and Urinary Sodium and Potassium Level in Type 2 DM Patients
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         Long-term use of sulfonylureas including chlorpropamide, is known to potentiate the antidiuretic action of arginine vasopressin (AVP), predisposing to hyponatremia.The present study was designed to evaluate the effect of long term use of glibenclamide on serum and urinary levels of sodium and potassium in Type 2 DM patients in Iraqi DM centers. Ninety eight patients with Type 2 DM who were maintained on different doses of glibenclamide for at least 1 year, attending the centre for Diabetes and Endocrinology in Al-Rusafa, Baghdad, were enrolled in the study, in addition to 15 normal healthy subjects. Patients were allocated into three groups according to the dose of glibenc

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Publication Date
Sun Oct 01 2023
Journal Name
Baghdad Science Journal
Estimation of Apelin Levels in Iraqi Patients with Type II Diabetic Peripheral Neuropathy
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Diabetes mellitus type 2 (T2DM) is a chronic and progressive condition, which affects people all around the world. The risk of complications increases with age if the disease is not managed properly. Diabetic neuropathy is caused by excessive blood glucose and lipid levels, resulting in nerve damage. Apelin is a peptide hormone that is found in different human organs, including the central nervous system and adipose tissue. The aim of this study is to estimate Apelin levels in diabetes type 2 and Diabetic peripheral Neuropathy (DPN) Iraqi patients and show the extent of peripheral nerve damage. The current study included 120 participants: 40 patients with Diabetes Mellitus, 40 patients with Diabetic peripheral Neuropathy, and 40 healthy

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