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Objective: This study aims to compare the effect of metformin monotherapy with the combination therapy of metformin and apple cider vinegar on the parameters of Body Mass Index and glycemic control of recently diagnosed type 2 diabetes mellitus patients. Methods: A total of 126 patients were enrolled in this open-label randomized controlled trial, divided into two parallel arms: Group I (Metformin 750 mg alone per day) and Group II (Metformin 750 mg+Apple Cider Vinegar 2 tablespoons per day) and assessed for weight, Body Mass Index, Fasting Blood Sugar and Hemoglobin A1c after which the post-treatment values of the aforementioned parameters were compared between the two groups. Informed consent from all patients and ethical approval from the institutional ethics board was obtained. A p-value of <0.05 was considered significant. Results: All the parameters underwent a significant reduction in the pre and post intra group comparison of each group (p-value<0.001). Moreover, a significant difference was found in the post-treatment comparisons of the Fasting Blood Sugar (p-value<0.001) and HbA1c (p-value=0.04) in between the two groups. However, no significant difference was obtained in the post-treatment comparisons of weight and Body Mass Index in between the two groups. Conclusion: Apple Cider Vinegar in combination with Metformin appears to be more effective in improving glycemic control versus Metformin monotherapy.
ABSTRACT
Background:Diabetes mellitus has remained the major concern for medical sciences researches duetoits deleterious effects on general, physical and mental health of patients. To understand the pathophysiology and to explore better treatment options for such kind of metabolic disorders it is necessary to generate the experimental animal models. To create diabetic animal models, streptozotocin has shown predominance in selectivity as a diabetogenic agent. While studying effects of any intervention in the diabetic animal models, being a cytotoxic drug streptozotocin may affect the study results by inhibiting highly replicating cells especially hematopoietic cells.Original ResearchArticle Aims:The aim of study was to analyze the effects of streptozotocin on various cellular components of blood such as RBCs, WBCs (Lymphocytes, Neutrophils, Eosinophils), Hb%, HCT and Platelets, at baseline,5thday and 15thday without any intervention.Study Design:Animal based Experimentalstudy.Place and duration of Study:The study was conducted at animal house of faculty of Pharmacy Ziauddin University Karachi, while laboratory work was performed at MDRL-1 Ziauddin University.Methodology:In Group A normal saline and in group B and C 60mg / kg streptozotocin diluted in normal saline was administered intraperitoneally. After the confirmation of induction of Diabetes in rats, on fifth day blood samples were drawn from Group A and B and were analyzed. While blood samples from group C weredrawn on fifteenth day.Results:Analysis of various hematological parameters on 5thday revealed that there was a decrease in the levels of Hb, HCT, RBCs and WBCs with an increase in platelet count in group B in comparison to group A (control). On the other hand, in Group C (15th day), blood cell counts (Hb, HCT, RBCs, WBCs, Lymphocytes, Neutrophils and platelets) seemed to recover from streptozotocin induced decline that was observed in group B, however did not reach the baselines as in group A(control).Conclusion:It is concluded that change in hematological parameters of rats after administration of streptozotocin is reversible. The blood parameters may recover near to base line values without any intervention within two weeks