Effects of sitagliptin and sitagliptin in combination with omega-3 on newly diagnosed type 2 diabetic Iraqi patients

Type 2 diabetes is a complex disease that is typically diagnosed in midlife and is characterized by progressive defects in insulin secretion and action. Objective: to compare the effects of dipeptidyl peptidase-4 (DDP-4) inhibitor sitagliptin and sitagliptin in combination with omega-3 on blood glucose level, serum insulin, high sensitivity C-reactive protein and oxidative stress state in newly diagnosed type 2 diabetic patients. Method: this is an open-label, randomized study carried out on 24 newly diagnosed type 2 diabetic patients. Patients were randomly divided into two groups and assigned for treatment with either sitagliptin (n=12) or sitagliptin in combination with omega-3 (n=12) for 2 months. The level of fasting blood glucose (FBG), post-prandial blood glucose (PPG), glycated hemoglobin (HbA1c), serum insulin, serum high sensitivity C-reactive protein (hs-CRP) and serum malondialdehyde (MDA) were calculated before and after one month and two months of treatment. Results: FBG, post prandial blood glucose and HbA1c significantly decreased in both treated groups after one month and two months of treatment. Serum insulin level increased non-significantly with sitagliptin and sitagliptin in combination with omega-3 after one and two months of treatment. Serum level of hs-CRP decreased significantly after two months of treatments with both sitagliptin and sitagliptin in combination with omega-3.  The level of serum MDA decreased significantly in group treated with sitagliptin in combination with omega-3 after one month and two months of treatment, while insignificant decrease observed after one and two months in sitagliptin treated group. Conclusion: omega-3 has no significant effect on glycemic control and insulin secretion but has beneficial effect on oxidative stress state, sitagliptin executes anti-inflammatory effect in patients with type 2 diabetes. Keywords: Type 2 DM, MDA, hs-CRP, sitagliptin, omega-