Effect of metformin and metformin-sulfonylurea on lipid profile of type 2 diabetes mellitus patients: A cross-sectional study

Background and Aims: In addition to lowering blood glucose levels, metformin also has a positive effect on the lipid profile by affecting gluconeogenesis and lipogenesis in the liver. Conversely, sulfonylurea is reported to possibly worsen the lipid profile and increase the risk of cardiovascular disease. Therefore, we would like to know whether there is a significant difference in the lipid profile of type 2 diabetes mellitus patients taking metformin as monotherapy and metformin-sulfonylurea as a combination since these two medicines are very commonly used in Indonesia. Methods: A cross-sectional study was performed on 88 patients with type 2 diabetes mellitus who were restricted on metformin or metformin-sulfonylurea for equal to or more than 1 year. Subjects on metformin (n=37) and metformin-sulfonylurea (n=51) were asked to fast for at least 8 hours before blood sampling. We measured the lipid parameters from subjects' blood samples using a standardized enzymatic method. Results: All basic characteristics of the study subjects in these two groups were matched. We found that total cholesterol, LDL-cholesterol, and triglyceride were lower and HDL-cholesterol was higher in the metformin group than the metformin-sulfonylurea group but not statistically significant (p>0.05). Multivariate analysis showed no significant differences for both therapies in any parameters before and after being adjusted by confounders. Only the increase in BMI contributed significantly to the increase in triglyceride. Conclusion: This study presents no statistical differences in lipid profile after =1 year consumption of metformin and metformin-sulfonylurea combination.