Aim: Insulin resistance (IR) is predominant in type 2 diabetic patients. This study aimed to investigate benefits from adding l-carnitine to ongoing glimepiride compared to glimepiride monotherapy on IR in diabetic patients who failed to achieve their glycemic goals on glimepiride monotherapy.
Methods: 58 patients were recruited from Internal Medicine Department, Tanta University Hospital, Egypt then prospectively randomized to receive their glimepiride dose 2 mg twice daily (group 1) or glimepiride 2 mg twice daily + l-carnitine 1 g m twice daily (group 2) for 6 months. Fasting blood samples were collected at baseline, 3 and 6 months after treatment for analysis of fasting and postprandial blood glucose [FBG &PPBG], glycated hemoglobin [HbA1c %], fasting insulin, extracellular part of insulin regulated aminopeptidase [IRAPe] as a novel marker, tumor necrosis factor-alpha [TNF-α], visfatin and lipid panel. Body mass index [BMI] and homeostasis model assessment of insulin resistance [HOMA-IR] were calculated. Data were statistically analyzed by SPSS using unpaired Student's t-test and one way analysis of variance; p ≤ 0.05 was considered statistically significant.
Results: The obtained data suggested that adding l-carnitine to glimepiride has a significantly beneficial effect on FBG, PPBG, HbA1c, fasting insulin, HOMA-IR index, IRAPe, TNF-α, visfatin and lipid panel parameters but doesn't have effect on BMI and blood pressure.
Conclusion: The co-administration of l-carnitine with glimepiride represents a new therapeutic strategy for better controlling diabetic patients as it resulted in more beneficial effects on direct and indirect biomarkers of insulin resistance than glimepiride alone.
Keywords: Diabetes; Glimepiride; HOMA-IR; Insulin regulated aminopeptidase (IRAPe); Insulin resistance; l-carnitine.
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