A CLINICAL STUDY OF THE USE OF • ASPIRIN AS ADJUVANT THERAPY IN DIABETIC PATIENTS TREATED WITH SULFONYLUREA DRUGS

Abstract

Diabetes mellitus is a chronic life-long syndrome characterized by disturbance of carbohydrates, fat and protein metabolism associated with absolute or relative insulin deficiency, insulin resistance and/or insulin action.

All causes of diabetes ultimately lead to hyperglycemia which is the hall mark of this disease syndrome. The disease has long term complications involving retinopathy, neuropathy, nephropathy, micro-and macro­ angiopathies.-

Non-insulin dependent diabetes mellitus is associated with reduced insulin sensitivity and defects in insulin secretion. However, it is still not clear which defect produces the development of the clinical• manifestations; insulin resistance or insulin deficiency. Insulin resistance, insulin secretion, glucose effectiveness and hepatic glucose production, all are causes for the development ofNIDDM.

Sulfonylurea drugs are hypoglycemic agents recommended for treatment of NIDDM patients, together with diet control. Glimepiride is a second generation . sulfonylurea which has advantages over conventional sulfonylureas, including lower dosage, rapid onset, longer duration of action and lower insulin level with a strong extrapancreatic activity.

Aspirin is a nonsteroidal anti-inflammatory agent which is used commonly to treat inflammation in wide variety of settings, including rheumatoid and other types of arthritis, musculoskeletal injury and acute rheumatic fever. Also, Aspirin is used in NIDDM patients to prevent the development of diabetic complications through the inhibition of thromboxane A2 and the inhibition of glycated hemoglobin formation by the acetylation of €-amino groups of lysine on albumin thus modifying its ligand binding properties and glycation.