Estudo de parâmetros bioquímicos em pacientes portadores de diabetes Mellitus tipo 2 em uso de hipoglicemiantes orais

Abstract

The type 2 diabetes mellitus is a clinicai condition that involves disorders in the metabolism of the carbohydrates, proteins and fat, associated to a relative or absolute insufficiency in the insulin secretion, as well as, to various degrees of resistance to this hormone. It is believed that this type of diabetes is directly associated to genetic factors, patient lifestyle and obesity. The involvement of the li ver is evident, given that this is the body organ responsible for the metabolism of innumerous components, such as, possible toxical effects that may come up resulting from the oral hypoglycemic therapy. However, very little importance has been given to the control of the hepatic function in patients with this pathology. Therefore, the clinicai characteristics .of 193 patients were investigated, and also the presence of metabolic aíterations through laboratory investigation on glycosylated hemoglobin dosages (HbA1c), fasting plasma glucose, lipidi profile, total serum proteins and albumin, bilirubin serum and enzyme markers of the hepatic function. Among these patients there was a great number of clinicai disorders such as dyslipedemias,. obesity and the systemic arterial hypertension. The most prescribed oral antidiabetic agentes for these patients were glibenclamida, metformin and the acarbose and, the longer was the diagnostic of the disease, the higher was the frequency of prescriptions of these drugs in a combined therapy. It could also be observed that among the patients with a regular glycemic control the choice for the monotherapy was predominant, while the combination therapy (two or more) was the choice for those with a bad glycemic control. It could also be observed high leveis of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) on 9.3% and 10.9% of the patients respectively, which was suggestive of hepatic harm. The majority of these aíterations was seen on those patients who make use of the combination therapy, which had more than ten years of the disease detection, but also, very frequent on patients with dislipidemias. The results showed that, despite of being discrete and limited to a small number of the patients studied, the possible hepatic aíterations were related to a longer diabetes diagnostic and to the use of more than one oral antidiabetic agents.