Hypoglycemic Agents and Changes in Oxidative Stress Indices, Electrolytes, and Cardiovascular Risk Factors in Type 2 Diabetes

Abstract

<b><i>Background:</i></b> Metabolic complications of type 2 diabetes (T2DM), including dyslipidemia, electrolyte imbalance, and oxidative stress, have been shown to be modulated by hypoglycemic agents. <b><i>Objective:</i></b> The lipid profile, electrolytes, and oxidative stress indices were evaluated in T2DM. <b><i>Methods:</i></b> Fifty T2DM patients on metformin (<i>n</i> = 23), insulin (<i>n</i> = 17), and insulin/metformin (<i>n</i> = 10) and 40 controls were studied. Fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), total antioxidant capacity (TAC), total plasma peroxide (TPP), and total calcium (Ca) values were determined colorimetrically, sodium (Na⁺) and potassium (K⁺) levels were determined by flame photometry, chloride (Cl^–) and bicarbonate (HCO₃^–) levels were determined by titration, and low-density lipoprotein cholesterol (LDL-C) levels, the atherogenic index of plasma (AIP), and the oxidative stress index (OSI) were determined by calculation. Data were analyzed using <i>t</i> test, analysis of variance, and Pearson’s correlation at <i>p</i> &#x3c; 0.05. <b><i>Results:</i></b> T2DM patients had higher lipid peroxidation (TPP and OSI), atherogenic lipids (higher LDL-C and AIP and lower HDL-C), and lower antioxidants compared to controls (<i>p</i> &#x3c; 0.05). T2DM patients with poor glycemic control had higher lipid peroxidation (higher TPP) and atherogenic lipids (TG and AIP) compared to those with good control (<i>p</i> &#x3c; 0.05). Patients with T2DM for &#x3e;5 years had higher protein glycosylation (higher HBA1c) and TC compared to those with T2DM for &#x3c;5 years (<i>p</i> &#x3c; 0.05). The class of hypoglycemic agent has no effect on the levels of all of the biochemical indices studied (<i>p</i> &#x3e; 0.05). HDL-C correlated negatively with TG (<i>r</i> = –0.347, <i>p</i> = 0.013), LDL-C (<i>r</i> = –0.322, <i>p</i> = 0.018), and AIP (<i>r</i> = –0.714, <i>p</i> = 0.000) in T2DM. <b><i>Conclusion:</i></b> Chronic T2DM and poor glycemic control are associated with reduced antioxidants, lipid peroxidation, and atherogenic dyslipidemia. Different hypoglycemic agents exert no differential effects on the metabolic indices of T2DM studied.