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.
56
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.
المقدمة
الحمد لله رب العالمين، وأفضل السلام وأتم التسليم على سيدنا محمد، وعلى آله وصحبه، أجمعين، وعلى من تبعهم بإحسان إلى يوم الدين، أما بعد.
فإن مسألة التعارض بين الرواية، والفتوى، من المسائل المشهورة عند الأصوليين والفقهاء،وهي من مباحث السنة عند الأصوليين، والتي تبنى عليها مسائل متعددة، وهي من أسباب اختلاف الفقهاء، فإذا ما روى أحد الرواة حديثاً معيناً، ثم عمل بخلاف ما روى، فللعل
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