Background: In type 2 diabetes mellitus there is a progressive loss of beta cell function. One new
approach yielding promising results is the use of the orally active dipeptidyl peptidase-4 (DPP-4)
inhibitors for type 2 diabetes mellitus.
Objective: This study aims at comparing the possible occurrence of macrovascular & microvascular
complications in Iraqis patients with type 2 diabetes mellitus using two combinations of drugs
metformin + glibenclamide and metformin + sitagliptin.
Methodology: Sixty eight T2DM patients and 34 normal healthy individuals as control group were
enrolled in this study and categorized in to two treatment groups. The group 1 (34 patients ) received
metformin 500 mg three times daily + glibenclamide 5 mg twice daily and the group 2 (34 patients)
received metformin 500 mg three times daily + sitagliptin 100 mg once daily. The urine sample was
collected for estimation of microalbumin urea and patients' examination was made by specialist
consultant endocrinologist.
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Results: The percentages of microalbuminurea were significantly (p<0.05) lower for group 2 patients
for 3 & 6 months of treatment (9.3%, 8.5%) respectively compared to group 1 (22.13%,18.12%)
respectively. The percentages of parasthesia, numbness and burning sensation of feet was
significantly(p<0.05) lower for group 2 patients for 3 & 6 months of treatment(16.71%,8.71%),
(20.59%,8.53) and (13.3,7.54) respectively as compared to group 1 (39.7%,34.36), (35.18,29.29)and
(37.88%,31.18%).The picture was same for postural hypotension & ischemic heart disease the
percentages were significantly (p<0.05) lower for group 2 patients for 3 & 6 months of treatment
(8.82%,7.12%)and (11.76%,8.82%) respectively as compared to group 1 (18.76%,14.65%) and
(17.65%,14.7%) respectively. The same was true for simple and proliferative retinopathy the
percentages were significantly (p<0.05) lower for group 2 patients for 3 & 6 months of treatment
(7.83%, 6.22%) and (2.82%,2.7%) respectively as compared to group 1 (15.76%,14.65%) and
(6.65%,7.71%) respectively.
Recommendations: Combination of metformin + sitagliptin significantly lower microvascular and
macrovascular complications than combination of metformin + glibenclamide.
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This research deals will the declared production planning operation in the general company of planting oils, which have great role in production operations management who had built mathematical model for correct non-linear programming according to discounting operation during raw materials or half-made materials purchasing operation which concentration of six main products by company but discount included just three products of raw materials, and there were six months taken from the 1st half of 2014 as a planning period has been chosen . Simulated annealing algorithm application on non-linear model which been more difficulty than possible solution when imposed restric
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