Effects of Gliclazide and Insulin Therapy on Thromboxane B 2 and 6-Keta-PGF 1\alpha Levels in Type II Diabetic Patients

Authors: Ahmet Gökhan ÖZGEN, Dilek ÖZMEN, Füsun HAMULU, Metin ÇETİN, Candeğer YILMAZ, Oya BAYINDIR

Abstract: Diabetic patients show hemobiological abnormalities such as increased platelet adhesiveness, platelet hyperaggregability, decreased platelet half life, hemorheological abnormalities and altered fibrinolysis, perhaps contributing to a procoagulative state. Gliclazide, a novel sulfonylurea in routine clinical use, was thought to have effects on prostanoid release and platelet function. We studied thromboxane A 2 metabolite; serum thomboxane B 2 (TXB 2 ) and the prostacyclin metabolite, 6-keto-PGF 1\alpha to assess the efficacy of gliclazide on these parameters. Two groups of age and sex matched type II diabetics were examined in the study. There were 16 subjects in each group (F:M= 10/6). The study period was 12 weeks. Gliclazide was given to the first group and insulin to the second. Following parameters were evaluated to see the effect of good control. HbA1c, cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, serum TXB 2 , 6- keto-PGF 1\alpha levels were measured before and after 3 months of therapy. There was no significant change in TXB 2 (2.24±0.2 to 2.08±0.4 nmol/L) and 6-keto-PGF 1\alpha (2.53±0.2 to 2.15±0.1 nmol/L,) levels in patients treated with insulin despite the amelioration in the HbA1c levels. Therapy with gliclazide was followed by a significant decrease in both serum TXB 2 levels (4.18±0.7 to 2.72±0.4, p=0.039) and 6- keto-PGF 1a (2.97±0.3 to 2.03±0.1, p=0.0047). TXB 2 /6-keto-PGF 1\alpha ratio did not change both after insulin (1.09±0.5 to 1.06±0.8) and gliclazide (1.31±0.9 to 1.32±0.4) treatment. According to the datas in our study, gliclazide therapy decreased TXB 2 levels as well as 6- keto-PGF 1\alpha levels so that ratio of TXB 2 /6- keto-PGF 1\alpha did not change, which would mean that gliclazide has neutral effect on diabetic microvascular complications.

Keywords: Non insulin dependent diabetes, gliclazide, thromboxane B2, 6-keto-PGF 1\alpha.

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