Effects of antioxidant supplement and metformin therapy on C-reactive protein and oxidative stress in patients with type 2 diabetes mellitus

Objectives: The study aims to compare the effects of metformin and antioxidant vitamins C and E on C-reactive protein (CRP) and oxidative/antioxidant status (represented by serum malondialehyde (MDA) and total antioxidant status (TAS) in newly diagnosed patients with Type 2 diabetes mellitus (T2DM) at baseline and after 3 months of therapy compared with the control group. Patients and Methods: The study was performed in Al-Wafaa Center of Diabetes Management and Research in Mosul, Iraq. They included 91 type 2 diabetic patients and 50 healthy controls. The patients were divided into two groups: The first group (n = 44) was received metformin alone orally for duration of 3 months and the second group (n = 47) was received metformin with vitamin C and E orally for duration of 3 months also. Fasting blood samples were obtained from both controls and patients (before and after treatment) and assays were done for determination of serum MDA, TAS, and CRP. Results: Compared with controls, patients serum levels of MDA, and CRP were significantly high and TAS were significantly lower. After 3 months of treatment, both patients groups reported significant reductions in serum levels of MDA, CRP and a significant increase in serum levels of TAS, compared with the pre-treatment levels. The present study found that there was a non significant difference in serum MDA levels between the two patients groups (p=0.026), whereas serum TAS levels was significantly higher and CRP was significantly lower in the second group as compared to the first group. Conclusion: The present study concluded that three months oral consumption of combined antioxidant vitamins C and E with metformin in patients with T2DM showed significantly beneficial effect on oxidative stress and inflammatory response compared with metformin alone. The findings of this study necessitate investigating the overall clinical impact of antioxidant treatment of type 2 diabetes mellitus to maintain good glycemic control

Comparison of the effect of losartan versus candasartan on uric acid levels in hypertensive patients

Background: It have been suggested by some studies that uric acid plays a causal role in the development of cardiovascular disease where as other studies concluded that uric acid merely reflects other concomitant risk factors, such as hypertension, insulin resistance, obesity, or lipid abnormality . Sartan drugs or angiotensin II receptor blockers do appear to lower uric acid levels (SUA). The clinical importance of this finding to patients with hypertension, or gout, or both is not yet known. The  present study was aimed to compare the effects of the antihypertensive drugs losartan and candasartan on blood pressure and uric acid level in hypertensive patients. Materials and Methods: A total of 80 newly diagnosed hypertensive patients were divided into two groups, with 40 patients in each group. Group 1 was given losartan (50 mg/day) and group 2 was given candasartan (8mg/day). A control group of 50 apparently healthy individuals was included. Blood pressure and uric acid were measured for controls and patients before and after drug administration.  Results:A significant  increase in blood pressure and uric acid were found in hypertensive patients before starting treatment (P<0.001), as compared with controls. After 2 months of treatment, the systolic and diastolic BP were significantly reduced in the both losartan and candasartan groups (P<0.001). Both drugs were similarly effective in reducing the blood pressure in patients with hypertension with no statistical significant difference between the two treatments.  Serum uric acid levels were only significantly reduced after 2 months of treatment with losartan (P < 0.001) but not with candasartan. Conclusions: Our findings suggest that both losartan and candasartan therapy were similarly effective in reducing blood pressure in patients with hypertension. Losartan, but not candasartan, was associated with a significant reduction in serum uric acid levels. Our findings suggest that the losartan is the drug of choice in patients with hypertension and hyperuricemia and gout