Indices of Inflammation, Oxidative Stress and DNA damage in T2DM patients with and without Insulin Therapy

Background: Type 2 Diabetes Mellitus is a metabolic disorder associated with excessive free radical generation and oxidative stress. Pharmacological interventions of T2DM targets on glycemic control and reduce the circulatory levels of oxidative stress and inflammation. Aim: The study compared the levels of oxidative stress, inflammation and the extent of DNA damage in T2DM patients undergoing different treatment modalities. Methods: 150 subjects recruited for this study belonged to the age group of 35-65 years. Participants were grouped as healthy controls (n=50), diabetics treated with oral hypoglycemic agent metformin (n=50) and diabetics undergoing combined therapy of insulin and metformin (n = 50). All the participants underwent the assessment of anthropometric measures, baseline blood pressure and blood samples were analysed for FBS, HbA1c, MDA, TAC, Hs-CRP and DNA damage. Results: Analysis using one-way ANOVA showed that despite the same age and duration of T2DM, patients in insulin therapy group had significantly higher levels of oxidative stress, inflammation and DNA damage when compared to T2DM patients treated with metformin alone. Further, significant correlations were observed for the above parameters with the duration of T2DM.Conclusion: The study concludes that oxidative stress, systemic inflammation and cellular senescence are more prominent in T2DM patients undergoing insulin therapy. Poor glycemic control observed in these patients could be attributed to increased insulin resistance as a consequence of oxidative stress and inflammation.