Effect of Metformin on C-reactive Protein in Type 2 Diabetes Mellitus Patients

Abstract

Diabetes mellitus (DM) is a complex endocrinology disease which requires a meticulous understanding of its pathogenesis and its complications to subdue it. It has been riddled with extensive micro and macro vascular complications which by itself has its own set of pathogenesis. There is a link between DM and cardiovascular disease (CVD), which is the most important cause of morbidity and mortality in diabetic patients. Cardiovascular risk factors such as obesity, hypertension and dyslipidemia are more common in patients with DM, placing them at increased risk for cardiac events.  In addition, they have found biological mechanisms associated with DM that independently increases the risk of CVD in diabetic patients.Metformin is the most commonly used antidiabetic agent derived from Gallegaofficinalis. Metformin provided greater protection against macro vascular complications than would be expected from its effects upon glycemic control alone. Hence this study evaluated the anti-inflammatory effect of metformin on C Reactive Protein (CRP) in patients. In this study fifty type 2 diabetes patients were enrolled in the study including 23 males and 27 females with mean age 40±4.33. FBS and PPBS baseline values expressed as Mean ± SD were 138.06±17.12 mg/dl and 223.12±30.63 mg/dl respectively. After 6 months of metformin therapy, FBS and PPBS were 91.64±10.55 mg/dl and 133.88±7.99 mg/dl respectively. HBA1C baseline value expressed as Mean ± SD was 7.966±0.85 %. After 6 months of metformin therapy, HBA1C improved to 6.8±0.93.hs-CRP baseline value expressed as Mean±SD was 3.4±1.16 mg/L. After 6 months of metformin therapy, hs - CRP effectively reduced to 1.7±0.81 mg/L. Prompt treatment intensification in such cases may thus be sensible. Further studies are needed to identify predictors of metformin treatment response, especially focusing on hs-CRP levels, lipid levels and genetic factors.