influence of fixed combination of metformin sr and glimepiride on carbohydrate, lipid metabolism and arterial wall stiffness in patients with diabetes mellitus type 2

To study the effect of hypoglycemic therapy with combination of glimepiride and metformin SR during 12 weeks on carbohydrate and lipid metabolism parameters, changes in the adipokines level in blood plasma and parameters of arterial wall stiffness of large arteries (aorta and its branches), we have observed 30 patients (18 of them — women) with type 2 diabetes mellitus aged 60.10 ± 1.08 years with an average duration of the underlying disease 5.7 ± 0.9 years. Results. Compared with baseline values, we have marked improvement of carbohydrate metabolism parameters. Thus, HbA1c level decreased by 1.7 % (p < 0.001), fasting glucose — by 22 % (p < 0.001), postprandial blood glucose — by 44 % (p < 0.001). In addition, on the background of therapy, there was an improvement in lipid metabolism: decrease of total cholesterol by 13.2 % (p < 0.01), low-density lipoproteins cholesterol — by 19.3 % (p < 0.01), triglycerides — by 30.6 % (p < 0.05). Changes in plasma adipokine level were noted: decline of adiponectin level from 5.98 ± 0.52 mg/ml to 4.45 ± 0.29 mg/ml (p < 0.01), as well as trend to increase of leptin level in blood plasma from 14.6 ± 2.3 ng/ml to 18.12 ± 2.90 ng/ml (p > 0.05). Changes in pulse wave velocity in the aorta and aortic augmentation index were statistically non-significant (p > 0.05). Changes in anthropometric parameters (body mass index, waist and hip circumference), as well as the total amount of adipose tissue, as defined by impedancemetry, were statistically non-significant (p > 0.05). Conclusions. Combined hypoglycemic therapy with glimepiride and metformin SR for 12 weeks resulted in a statistically significant improvement of carbohydrate and lipid metabolism, had no effect on anthropometric parameters and the total amount of adipose tissue, prevented the progression of arteriosclerosis of large vessels according to the indicators of arterial wall stiffness.