Study on the effect of oral hypoglycaemic agents on arterial stiffness among Malays with type II diabetes mellitus

Objective: To determine the effect of two regimens of oral hypoglycaemic agents: sulphonylurea monotherapy and metformin in combination with sulphonylurea on arterial stiffness. Methods: A case control study was conducted at the Family Medicine and Diabetic Clinic, HUSM from May 2004 until May 2005. Sixty subjects receiving sulphonylurea alone and ninety subjects on combination therapy with metformin participated in this study. A simple random sampling method using a draw lot was used to select 51 subjects for each group. Augmentation index (AI) was measured using the Sphygmocor apparatus and all measurements were performed by the investigators after an earlier validation study. The mean augmentation index measurements were analyzed. Results: The mean AI values of diabetic subjects treated with sulphonylurea monotherapy and a combination with metformin were 140.51 ± 11.42 vs 140.14 ± 12.86, p= 0.877. AI values were significantly higher in females compared with males (143.23 ± 10.60 vs 135.82 ± 13.01, 95% CI: -12.07, -2.73, p = 0.002). Duration of diabetes (in years) was significantly less (3.46 ± 3.16 vs 5.41 ± 3.66, p = 0.005) for sulphonylurea monotherapy patients compared with combination therapy patients. Conclusion: This study shows that sulphonylurea monotherapy and metformin in combination with sulphonylurea have similar effects on arterial stiffness in type 2 diabetes subjects. Diabetes is associated with a greater arterial stiffness in women compared with men.