Diabetes Mellitus, Type 2 Clinical Trial
Official title:
The Effect of Esomeprazole on Gastrin Levels and Glycaemic Regulation of Type 2 Diabetes: A Prospective Trial
The investigators aimed to prospectively investigate the effects of esomeprazole on glycaemic control in patients with type 2 diabetes mellitus. The investigators also aimed to associate this effect with gastrin levels. Thirty-two type 2 diabetes mellitus objects were recruited into intervention (n=16) and control (n=16) groups. The participants in the intervention group were prescribed 40 mg of esomeprazole treatment for three months. At the beginning of the study and at month 3, HbA1c level (%) and gastrin levels (pmol/L) of participants were assessed. Then the baseline and 3rd month data of groups were compared.
Thirty-two patients recruited in the study. All the participants had a diagnosis of T2DM and
had at least 1-year follow-up in Endocrinology outpatient clinic. All the study participants
were chosen from regulated diabetic subjects whose diabetes treatment were not amended. The
investigators excluded any cases needing revision in their treatment strategies due to
ethical issues. Participants were recruited in intervention and control groups. Each group
consisted of 16 diabetic subjects. Groups were matched for age, diabetes duration, body mass
index, baseline HbA1c level and gastrin levels. In the intervention group, all participants
had various degrees of symptoms for functional dyspepsia, gastro-oesophageal reflux,
gastritis or duodenitis and all of them were prescribed 40 mg of esomeprazole treatment for
three months. The control group consisted of without gastric complaints, thus who did not
receive PPI drugs. This group was followed-up without any intervention for three months. All
subjects were advised for dietary recommendations and lifestyle modifications. At the end of
the study, all of them reported their adherence to these recommendations. Subjects, on
pioglitazone and incretin-based therapies; subjects with a history of gastrointestinal
surgery, liver or kidney disease, diabetic macro- or microvascular complications; who are
lactating or pregnant, were excluded. Subjects on any PPI treatment or had a history of PPI
use in a 3 months period before the study were not eligible.
The height was measured in the standing position with a tape measure fixed on the wall. Body
weight, fat mass, and fat percentage were measured using a conventional bioelectrical
impedance (BIA) device (TBF-300, Tanita corp., Tokyo, Japan). All measurements were completed
after a mean period of 60 seconds. Subjects were asked not to consume alcohol during the
24-hour period before assessment and caffeine for the 4 hours before assessment. All
accessories, such as heavy clothing, rings, and earrings, which could affect the
measurements, were removed before the assessment. Body mass index was calculated as weight in
kilograms divided by the square of the height in meters (kg/m2). All measurements were
performed by one physician after the participants had fasted for at least 8 hours. Fasting
blood glucose (FBG) (mg/dl.), triglyceride (mg/dL), high-density lipoprotein cholesterol
(HDL-c, mg/dL), low-density lipoprotein cholesterol (LDL-c, mg/dL), thyroid-stimulating
hormone (TSH) (IU/mL), HbA1c level (%) and gastrin levels (pmol/L) were measured by using a
sample of venous blood. TSH assays were performed via immunochemiluminescent assay (Architect
c8200, Abbott). FBG, LDL-c, HDL-c, and triglyceride levels were measured by using the
hexokinase 7/G-6-PDH method, a measured liquid-selective detergent method, an
accelerator-selective detergent method, and a glycerol phosphate oxidase method (Architect
c8200, Abbott), respectively. HbA1c was via the enzymatic method using Architect c4000
(Abbott) system from human complete blood and hemolysate. Serum gastrin level was measured by
a competitive radioimmunoassay using a rabbit antiserum raised against a gastrin 17 albumin
conjugate (DiaSource ImmunoAssasys S.A., Louvain-la-Neuve, Belgium). According to the
manufacturer, the range of gastrin level is 11-54 pmol/L and the lowest detectable
concentration is 5 pmol/L. All measurements were performed both at baseline and the follow-up
visit.
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