Effect Of Short Term Intensive Glycemic Control With Three Different Treatment Types On Serum Adiponectin And Resistin Levels In Newly Diagnosed Type2Diabetic Patients

Objective: To compare the levels of serum resistin and adiponectin in newlydiagnosed type2diabetic patients who undergone short term intensive glycemic controlwith three types of treatment namely: insulin alone, oral hypoglycemic agents (OHA),and combined insulin and OHA.Methods: A total of fifty-nine newly diagnosed type2diabetic patients (mean age45±10.5years) were enrolled and were randomly divided into three groups, namely (1)the insulin treatment group, which received intensive insulin therapy (n=10), includingcontinuous subcutaneous insulin infusion (CSII) and multiple daily injection (MDI);(2)the oral group, which received OHA, namely metformin, glimiperide, acarbose as dualor triple therapy (n=18);(3) the combined group, which received both insulin andOHA (n=21). For all the3groups, serum levels of adiponectin and resistin, Body massindex (BMI), Glycated haemoglobin (HbA1C), fasting plasma glucose (FPG),triglyceride (TG), total cholesterol (TC), High-density lipoprotein cholesterol (HDL-C),Low density lipoprotein cholesterol (LDL-C), were measured at baseline and after twoweeks treatment.Results:In the insulin group after2weeks treatment, a statistically significant decrease inthe HbA1C(10.66±0.65to9.07±0.55%) and FPG (8.88±0.61to6.69±0.44, p<0.05mmol/l) was recorded. There was no significant change in resistin (3.26±0.31to3.27±0.41μg/ml) or adiponectin levels (2.83±0.12to2.88±0.16μg/ml),(p>0.05). Afterinsulin treatment plasma adiponectin levels correlated positively with TG (r=0.64, p<0.05). Plasma resistin levels before treatment correlated negatively with TG(r=-0.84,p<0.05),TC (r=-0.91, p<0.01), HDL-C (r=-0.88. p <0.01) and LDL-C (r=-0.91, p< 0.05). After treatment with insulin, the resistin level also correlated negatively with theabove-named parameters namely TG (r=-0.81, p <0.05), TC (r=-0.87. p <0.05),HDL-C (r=-0.86. p<0.05) and LDL-C (r=-0.74, p<0.05).In the exclusive OHA group, after2weeks treatment, there was a statisticallysignificant decrease in FPG (10.41±0.79to6.86±0.63mmol/l), HbA1C(10.02±0.74to9.20±0.60%), BW (77.36±3.65to75.71±3.52kg), BMI (26.61±0.96to26.03±0.92kg/m~2), TG (135.75±33.99to91.95±20.94mg/dl), LDL (83.47±16.12to58.52±11.60mg/dl) and HDL (36.39±6.89to27.61±5.17mg/dl)(p <0.05). There was adecrease in adiponectin level (3.19±0.17to3.15±0.20μg/ml) and an increase in resistinlevel (2.15±0.31to2.18±0.27μg/ml) but both were statistically insignificant (p>0.05).Adiponectin level correlated positively with HbA1Cboth before (r=0.52, p <0.05) andafter treatment (r=0.56, p<0.05). After treatment a negative correlation was obtainedbetween resistin and TG (r=-0.52, p<0.05), HDL-C (r=-0.51, p<0.05) and TC (r=-0.53, p<0.05).In the combined insulin and OHA group, after2weeks treatment, there was asignificant decrease in HbA1C(10.51±0.35to9.40±0.32%), FPG (10.85±0.69to6.29±0.28mmol/l) and HDL (9.36±4.21to8.45±3.91mg/dl)(p<0.05). There was anon-significant change in both adiponectin level (3.32±0.21to3.19±0.21μg/ml) andresistin level (3.44±0.43to3.43±1.6)(p>0.05). In the combined treatment group,resistin level after treatment correlated negatively with TG(r=-0.59, p <0.05), TC,(r=-0.56, p <0.05), HDL-C (r=-0.58, p <0.05) and LDL-C (r=-0.59, p <0.05).Inter–group comparison showed no significant difference of adiponectin or resistinlevels among the three groups neither before nor after treatment.(p>0.05)Conclusions:Neither of the three types of treatment caused a statistically significant change inthe level of adiponectin and resistin. Hence, it cannot be concluded that one treatmenttype is better than the other in terms of influencing the level of adiponectin and resistin.