Mohammad Waqas, Muhammad Idrees, Saima Qayyum, Muhammad Ihtesham, Mohsin Shafi, Inayat U Rahman.
Metformin Modulates Serum CA 19-9 and its Related Factors More Effectively Than Glibenclamide in Diabetic patients.
J Med Sci May ;30(03):212-5.

Objective: CA 19-9 is a marker that shows the relapse of tumors. Raised CA 19-9 in diabetes mellitus cases and the effect of hypoglycemic agents on the marker prompted us to compare the effect of metformin and glibenclamide on CA 19-9 levels in patients with diabetes mellitus. Material & Methods: It is a randomized control trial (RCT). Normal control (group A1) included 40 staff members from KTH/KMC. A total number of 79 patients with type 2 diabetes mellitus were randomized into two groups; group A2 (n=39) who took metformin (500 mg/day) and group A3 (n=40) received glibenclamide (2.5 mg/day). The study was conducted for 6 months and variables including fasting blood glucose, blood lipids, plasma sialic acid, HbA1-c, insulin and C-peptide, CA 19-9, and insulin resistance were measured initially and at week 10. Results: At the endpoint, there were reductions in FBG and HbA1C levels among metformin and glibenclamide groups compared to baseline (p<0.003, p<0.001, and p<0.05, p<=0.05 respectively). The metformin group also showed a significant reduction in CA 19-9 level from baseline (p<=0.05) and the same was the case for PSA (p<0.04) but the effect of glibenclamide on CA 19-9 was negligible and PSA slightly increased (deteriorated) from baseline. Between groups comparison at the endpoint showed a significantly high level of PSA in the glibenclamide group than in the metformin group (p<=0.05). Insulin, HOMA-IR, and C-peptide levels improved in both groups from baseline. The favorable effects of metformin on blood lipids and body weight were more than glibenclamide. Correlation studies revealed a significantly positive correlation (p<=0.05) of CA 19-9 with FBG, HbA1-c, PSA, insulin, and triglyceride levels in the metformin group, and FBG, HbA1-c, PSA, and total cholesterol in glibenclamide group. Conclusions: From these findings, we suggest greater beneficial effects of metformin on CA 19-9 and other related factors than glibenclamide.

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