DM patients under Metformin hypoglycemic drug (Group A) and DM patients under Glimepiride (Group B) were categorized into groups according to Age, sex, diabetes chronic complications, dose per day, duration of Metformin or Glimepiride used and the level of Hb A1C.
patients using Metformin were 26 females and 24 males with mean age of 55.4 years old, 22% of them were us500 mg and 78% taking 850 mg Metformin. Patients on Glimepiride were 27 females and 19 males and 27 females with mean age of 56.4 years old taking diffferent doses(2mg = 17.3%, 3mg = 10.9%, 4mg = 65.2%, 5mg = 6.6%).
Study population ages were categorized into less than 40, 40–50 ,< 50–60, < 60–70 and more than 70 years their frequencies were [Metformin=(2%, 36%, 38%, 16%, 8 %), Glimepiride=(6.6%, 28.9%, 33.4%, 24.5%, 6.6%),respectively.
drugs durations were divided in to less than 5, 5–10 ,< 10–15, < 15–20 and more than 20 years their percentages were [Metformin=(30%, 36%, 12%, 14%, 8 %), Glimepiride=(44%, 39%, 9%, 7%, 2%)],respectively. According to the presence of associated complications in Metformin’s and Glimepiride’s study populations 10% and 4%, were with retinopathy, 20% and 40% with foot ulcer and patients with no detected complications were 70%, 56 %, respectively.
DM Patients with HbA1C less than 6% were 15%, 6–7%, were 16% and more than 7% were 69%.
The mean, standard deviation and P-value of the measured platelet count and indices of the study population and compared with the control group are shown in table (1).
Table 1
Comparison in platelet count and indices between oral hypoglycemic drugs study population and control group
Parameters
|
Mean Metformin ± SD
(Group A)
|
Mean Glimepiride ± SD
(Group B)
|
Mean Non diabetes ± SD
(Group C)
|
p.value
(A vs C)
|
p.value
(B vs C)
|
p.value
(A vs B)
|
Platelet count(x109/ l)
|
319.2 ± 138.6
|
298 ± 114
|
280.1 ± 77.7
|
.087
|
.378
|
.423
|
MPV ( fl)
|
9 ± .83
|
9.4 ± .93
|
9.7 ± .86
|
.000
|
.153
|
.044
|
PDW ( fl)
|
10 ± 1.2
|
11 ± 1.9
|
11.8 ± 1.6
|
.000
|
.028
|
.004
|
P-LCR (%)
|
17.8 ± 6.5
|
20.7 ± 7.2
|
22.9 ± 6.4
|
.000
|
.117
|
.039
|
p. value <0.05 is considered significant SD=standard deviation
Table 2
comparisons between platelet count and platelet indices in DM patients using Metformin as oral hypoglycemic drug according to age, gender, complications, dose, Metformin using duration and HbA1C groups.
Characteristic
|
groups
|
Mean Platelet count
(x 109/ l) ± S.D
|
Mean MPV ( fl) ± S.D
|
Mean PDW( fl) ±S.D
|
Mean P-LCR (%)
±S.D
|
Age (years)
|
40 to 50
|
298.39 ± 76.1
|
9.38 ± .9
|
10.6 ± 1.7
|
20.25 ± 6.8
|
> 50 to 60
|
346.26 ± 194.9
|
8.97 ± .8
|
10.2 ± 1.6
|
16.87 ± 6.5
|
> 60 to 70
|
319.88 ± 123.2
|
8.68 ± .6
|
10.8 ± 2.5
|
16.21 ± 3.4
|
more than 70
|
261.25 ± 57.1
|
8.98 ± .7
|
10.38 ± 1.5
|
16.18 ± 8.2
|
p.value
|
.492
|
.199
|
.871
|
.299
|
Gender
|
|
|
|
|
|
Male
|
303.96 ± 132.8
|
9.05 ± .97
|
10.8 ± 2
|
18.09 ± 7.5
|
Female
|
333.27 ± 144.9
|
9.05 ± .7
|
10 ± 1.3
|
17.5 ± 5.4
|
p.value
|
.461
|
.987
|
.099
|
.751
|
Complications
|
|
|
|
|
|
Eye
|
222.8 ± 55.7
|
9.66 ± .38
|
10.54 ± .75
|
22.14 ± 2.8
|
Foot
|
437.6 ± 238.4
|
8.7 ± .92
|
9.47 ± 1.3
|
14.97 ± 7.3
|
No complication
|
299.14 ± 79.8
|
9.06 ± .82
|
10.7 ± 1.9
|
17.97 ± 6.3
|
p.value
|
.050
|
.107
|
.171
|
.123
|
Dose (day)
|
|
|
|
|
|
500mg
|
309.87 ± 136.4
|
8.98 ± .7
|
10.38 ± 1.8
|
17.14 ± 5.9
|
850mg
|
352.27 ± 147.7
|
9.28 ± 1.1
|
10.48 ± 1.9
|
20.09 ± 8.1
|
p.value
|
.376
|
.297
|
.452
|
.184
|
Metformin’s duration
(years)
|
|
|
|
|
|
less than 5
|
267.2 ± 66.5
|
8.99 ± .82
|
10.5 ± 1.8
|
17.28 ± 6.9
|
5 to 10
|
315.78 ± 111.8
|
9.17 ± .98
|
10.4 ± 2
|
18.71 ± 6.9
|
10 to 15
|
433.83 ± 245
|
9.02 ± .95
|
10.2 ± 1.6
|
16.52 ± 8.3
|
15 to 20
|
295.57 ± 121.7
|
8.96 ± .45
|
10.5 ± 1.5
|
17.69 ± 3.5
|
more than 20
|
399 ± 207
|
8.95 ± .86
|
10.1 ± 1.7
|
17.6 ± 6.7
|
p.value
|
.330
|
.967
|
.993
|
957
|
Hb A1c
(%)
|
|
|
|
|
|
less than 6%
|
385.76 ± 244.9
|
9.24 ± .82
|
10.3 ± 1.4
|
18.9 ± 6
|
6 to 7 %
|
273.5 ± 57.6
|
9.3 ± .6
|
10.6 ± 1.6
|
20 ± 4.8
|
More than 7%
|
316.8 ± 118.4
|
8.9 ± .89
|
10.4 ± 1.9
|
16.8 ± 6.9
|
p.value
|
.414
|
.365
|
.912
|
.343
|
Table 3
comparison between platelet count and platelet indices in DM patients using Glimepiride as oral hypoglycemic drug according to age, gender, complications, dose, Glimepiride using duration and HbA1C groups.
Characteristic
|
groups
|
Mean Platelet count (x 109/ l) ± S.D
|
Mean MPV( fl) ±S.D
|
Mean PDW( fl)
±S.D
|
Mean P-LCR (%) ±S.D
|
Age (years)
|
Less than 40
|
250 ± 90.4
|
10 ± .32
|
12.27 ± 1.4
|
22.8 ± 8.4
|
40 to 50
|
266.8 ± 79.25
|
9.5 ± 1
|
11 ± 1.9
|
21.5 ± 7.8
|
> 50 to 60
|
337.6 ± 146.95
|
9.2 ± 1.1
|
10.6 ± 2.5
|
19.2 ± 8.5
|
> 60 to 70
|
303.3 ± 105.46
|
9.3 ± .72
|
10.7 ± 1.4
|
20 ± 4.8
|
more than 70
|
288.3 ± 78.5
|
9.4 ± .78
|
11.7 ± 1.7
|
22 ± 7.5
|
p.value
|
.500
|
.675
|
.681
|
.881
|
Gender
|
|
|
|
|
|
Male
|
288.4 ± 288.40
|
9.1 ± .92
|
10.5 ± 1.7
|
18.99 ± 6.68
|
Female
|
309.7 ± 103.94
|
9.6 ± .93
|
11.3 ± 2
|
21.67 ± 7.6
|
p.value
|
.535
|
.117
|
.181
|
.216
|
Complications
|
|
|
|
|
|
Foot
|
351.7 ± 141.15
|
8.9 ± .87
|
9.97 ± 1.4
|
17.2 ± 5.9
|
No complication
|
269.4 ± 79.67
|
9.7 ± .89
|
11.6 ± 2
|
22.6 ± 7.4
|
p.value
|
.034
|
.007
|
.006
|
.014
|
Dose (day)
|
|
|
|
|
|
2mg
|
266.38 ± 107.7
|
9.8 ± 1
|
11.7 ± 2.3
|
24.25 ± 8.46
|
3mg
|
273.8 ± 112
|
9.2 ± .95
|
10.16 ± 1.5
|
18.5 ± 6.9
|
4mg
|
318.2 ± 117.5
|
9.3 ± .96
|
10.8 ± 1.98
|
19.6 ± 7.16
|
5mg
|
258 ± 110.1
|
9.5 ± .23
|
11.7 ± 1.35
|
22.4 ± 2.78
|
p.value
|
.559
|
.548
|
.468
|
.377
|
Glimepiride’s duration
(years)
|
|
|
|
|
|
less than 5
|
285.7 ± 84.9
|
9.3 ± .85
|
10.6 ± 1.5
|
19.4 ± 6.4
|
5 to 10
|
298.3 ± 110.2
|
9.4 ± 1.16
|
11.4 ± 2.6
|
21.5 ± 9
|
10 to 15
|
247.3 ± 16.7
|
9.6 ± .52
|
10.8 ± .68
|
21.1 ± 3.1
|
15 to 20
|
488.7 ± 242.3
|
9 ± .46
|
10.4 ± 1.2
|
17.6 ± 4
|
p.value
|
.021
|
.880
|
.408
|
.746
|
Hb A1c
(%)
|
|
|
|
|
|
less than 6%
|
222.7 ± 65.9
|
10.2 ± 1.1
|
12.8 ± 2.4
|
27.7 ± 8.8
|
6 to 7%
|
305.8 ± 70.9
|
9.5 ± 1
|
10.9 ± 1.8
|
20.5 ± 7.7
|
More than 7%
|
315.4 ± 120.4
|
9.2 ± .84
|
10.6 ± 1.7
|
19 ± 6.1
|
p.value
|
.145
|
.034
|
.016
|
.012
|
Statistically insignificance difference was detected on platelet count between patients took Metformin, Glimepiride and healthy controls. Both drugs have reduced platelet indices (MPV, PLCR, PDW) when compared with the control group but platelet indices were much more reduced in patients using Metformin than those taking Glimepiride as oral hypoglycemic drug as shown in (Table 1).
There was insignificant difference in platelet count and indices among those using Metformin in term of sex, age, dose, drug duration, associated complications and HbA1C level as shown in (Table 2). But among those using Glimepiride as oral hypoglycemic drug, there was increased platelet count and decreased platelet indices in patients with foot ulcers than patients without complications. Also increased platelet indices in patients with HbA1C level less than 6% in contrast to those with HbA1C more than 7%.
Glimepiride diabetic patients from 15 to 20 years old have increased platelet count (488.7) than patients used Glimepiride less than 15 years (247.3), less than 10 years (298.3) and less than 5 years (285.7). There was insignificant difference in term of age, gender, and dose in Glimepiride users as shown in (Table 3).