Synergistic Effects of Omeprazole and Metformin on Glycemic Control in Type 2 Diabetic Patients. A Randomized Clinical Study
Keywords:
Proton pump inhibitor, omeprazole, metformin, HbA1C, FBG, SGPTAbstract
Objective: To evaluate the synergistic effects of omeprazole and metformin on glycemic control among patients
with type 2 diabetes.
Method: This randomized interventional clinical study was conducted in the Department of Pharmacology and Therapeutics, Basic Medical Sciences Institute, Jinnah post graduate medical Centre Karachi. Total study period was 10 months (august 2014-June2015) with individual study period of 3 months (90 days), Eighty(80) type 2 diabetic patients (40 in each group) of either sex, ages ranged from 30 to 60 years without any known comorbidities were included. Group-A was treated with metformin alone and Group-B was treated with metformin plus omeprazole. Efficacy was evaluated by means of FBG, and HbA1C.
Results: Out of 80 patients, 74 had completed the study. Group B showed significant reduction (P=0.001) in terms of FBS and HbA1c level when comparison was done on day 90 with Group A and within group as compared to day 0.
Conclusion:-Addition of proton pump inhibitor with metformin was found effective in achieving better glycemic
control in type 2 diabetic patients.
Downloads
References
Piero MN, Nzaro GM and Njagi JM. Diabetes mellitus a devastating metabolic disorder. Asian J Biomed Pharmaceu Sci. 2014; 04: 1-7.
Ansari RM, Dixon JB and Coles J. Type 2 diabetes: Challenges to health care system of Pakistan. Intern J Diabetes Res. 2015; 4:7-12.
Forbes JM and Cooper ME. Mechanisms of diabetic complications. Physiol Rev. 2013; 93:137–88.
Nyenwe EA, Jerkins TW, Umpierre GE and Kitabchi AE. Management of type 2 diabetes: Evolving strategies for the treatment of patients with type 2 diabetes. J Metabol. 2011; 60: 1-23.
DeFronzo RA, Eldor R and Abdul Ghani M. Pathophysiologic approach to therapy in patients with newly diagnosed type 2 diabetes.
Diabetes Care. 2013; 36:127-8.
Shin JM and Kim N. Pharmacokinetics and pharmacodynamics of the proton pump inhibitors. J Neurogasteroenterol Motil. 2013;
:25-35.
Takebayashi K and Inukai T. Effect of proton pump inhibitors on glycemic control in patient with diabetes. World J Diabetes 2015; 6:1122-31.
Barchetta I, Guglielmi C, Bertoccini L, Calella D, Manfrini S, Secchi C, Pozzilli P, Cavallo MG. Therapy with proton pump inhibitors in
patients with type 2 diabetes is independently associated with improved glycometabolic control. Acta Diabetol. 2015; 52: 873-80.
Crouch MA, Mefford IN and Wade EU. Proton pump inhibitor therapy associated with lower glycosylated hemoglobin levels in type 2 diabetes. J Am Board Fam Med. 2012; 25:50-4.
(http://www.openepi.com/sample size/ssporpor.htm).
Inci F, Atmaca M, Ozturk M, Yildiz S, Koceroglu R, Sekeroglu R, Ipekci SH, Kebapcilar. Pantoprazole may improve beta cell function and diabetes mellitus. JEndocrional Invest. 2014;37(5):449-54
Mefford IN, Wade EU. Proton pump inhibitors as a treatment method for type II diabetes. Med Hypotheses. 2009; 73:29-32.
Singh PK, Hota D, Dutta P, Sachdeva N, Chakrabarti A, Srinivasan A, Singh I, Bhansali A. Pantoprazole improves glycemic control in
type 2 diabetes: a randomized, double-blind, placebo-controlled trial. J Clin Endocrinol Metab. 2012; 97:2105– 08.
Bödvarsdóttir TB, Hove KD, Gotfredsen CF, et al. Treatment with a proton pump inhibitor improves glycaemic control in Psammomys obesus, a model of type 2 diabetes. Diabetologia. 2010; 53: 2220-23.
Boj-Carceller D, Bocos-Terraz P, Moreno-Vernis M, Sanz-Paris A, Trincado-Aznar P, Albero-Gamboa R. Are proton pump inhibitors
a new anti-diabetic drug? A cross sectional study.World J Diabetes.2011; 2:217-20.
Han N, Oh M, Park SM, Kim YJ, Lee EJ, Kim TK, Kim TN, Kwon MJ, Kim MK, Lee SH, Rhee BD and ParkJH.The effect of proton pump
inhibitors on glycated hemoglobin levels in patients with type2 diabetes mellitus.2015;:24-8.
Koop H, Klein M, Arnold R. Serum gastrin levels during long-term omeprazole treatment. Aliment Pharmacol Ther. 1990; 4: 131-8.
Tellez N, Joanny G, Escoriza J, Vilaseca M, Montanya E. Gastrin treatment stimulates -cell regeneration and improves glucose tolerance in 95% pancreatectomized rats. Endocrinology 2011; 2:2580-8.
Sanaka M, Yamamoto T, Kuyama Y. Effects of proton pump inhibitors on gastric emptying: a systematic review. Dig Dis
Sci 2010; 55: 2431-40.
Hirst JA, Farmer AJ, Dyar A, Lung TWC and Stevens RJ. Estimating the effect of sulfonylurea on HbA1c in diabetes: a
systematic review and meta-analysis. Diabetologia 2013; 56:973-84.
Rau TT, Sonst A, Rogler A, Burnat G, Neumann H, Oeckl K, Neuhuber W, Dimmler A, Faller G, Brzozowski T, Hartmann A, Konturek PC. Gastrin mediated down regulation of ghrelin and its pathophysiological role in atrophic gastritis. J Physiol Pharmacol. 2013; 64:
-25.
Cao Y, Cao X, Liu XM. Expression of cholecystokinin-2 receptor in rat and human L cells and the stimulation of glucagon-like peptide-1 secretion by gastrin treatment. Acta Histochem. 2015; 117: 205-21.
Kim A. Chung, Yoon SH, Yu KS, Lim KS, Cho JY, Lee H, Jang IJ, Chung JY. Effects of proton pump inhibitors on metformin pharmacokinetics and pharmacodynamics. Drug Metab Dispos 2014; 42:1174-9.
Antoniou T, MacDonald EM, Hollands S, et al. Proton pump inhibitors and the risk of acute kidney injury in older patients: a
population-based cohort study. CMAJ 2015; 3:71.166-71.
Xie Y, Bowe B, Li T, et al. Proton Pump Inhibitors and Risk of Incident CKD anProgression to ESRD. J Am Soc Nephrol
; 27:3153.
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Fizzah Ali, Moosa Khan, Kausar Aamir, Muhammad Azhar Mughal
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles published in the Journal of Dow University of Health Sciences are distributed under the terms of the Creative Commons Attribution Non-Commercial License https://creativecommons.org/ licenses/by-nc/4.0/. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. 
