Effect of a combination of gliptin and metformin on serum vitamin B12, folic acid, and ferritin levels

SUMMARY OBJECTIVE: The primary objective of this study was to explore the impact of metformin and metformin/gliptin combination therapy on the serum concentrations of vitamin B12, ferritin, and folic acid in individuals diagnosed with type 2 diabetes. METHODS: This study included 118 patients, classified into two groups: 59 patients using only metformin and 59 patients using a combination of metformin/gliptin. Among the latter group, 35 patients used vildagliptin/metformin, and 24 used sitagliptin/metformin. The study recorded the demographic data such as the age and gender of the patients, as well as their initial and 1-year follow-up blood parameters. RESULTS: Folic acid decreased significantly in the metformin group but not in the metformin/gliptin group. Vitamin B12 and ferritin decreased significantly in both groups. The decrease in vitamin B12 and ferritin was not significantly different between the two groups. The decrease in fasting plasma glucose was more significant in the metformin/gliptin group than in the metformin group. CONCLUSION: After 1 year, both groups taking metformin and metformin/gliptin showed low serum ferritin and vitamin B12 levels. Therefore, vitamin B12 levels in patients using these drugs should be closely monitored. Ferritin levels can be used to indicate whether glycemic control has been achieved.

Is the COVID-19 disease associated with de novo nephritic syndrome?

SUMMARY INTRODUCTION: This study aims to determine the incidence of de novo nephritic syndrome (NS) in COVID-19 patients and identify its associated factors. METHODS: All ward patients with COVID-19 pneumonia were investigated. After determining the inclusion and exclusion criteria, the study population was identified. The urine dipstick test and urine protein creatinine ratio (UPCR) measurements were performed. Patients with de novo NS findings, nasopharyngeal swab, and urine RT-PCR tests were performed simultaneously RESULTS: This descriptive cross-sectional study was conducted with 21 patients with COVID-19. The mean age of the patients was 42.2±8.8 years, and 71.4% of them were male. The mean duration of follow-up was 28.4±9.3 days. The urine RT-PCR test was positive in one patient (4.8%). Improvements were observed in hematuria by 71.4%, and proteinuria by 85.7% at the end of the follow-up. A significant decrease in the measured UPCR was found in comparison to the baseline(P=0.000). Also, improvements were recorded in the complete blood counts, inflammatory parameters, ferritin, and coagulation tests, compared to the baseline. There was a positive correlation between baseline UPCR and ferritin, and a negative correlation between baseline UPCR and sodium values CONCLUSION: COVID-19-induced de novo nephritic syndrome may occur mainly due to tubulointerstitial involvement and often results in spontaneous remission. However, why these findings were not present in all patients who had no comorbidities is not clear.

RESUMO INTRODUÇÃO: Este estudo tem como objetivo determinar a incidência da síndrome nefrítica de novo (SN) em pacientes com COVID-19 e identificar os fatores associados. MÉTODOS: Todos os pacientes da enfermaria com pneumonia por COVID-19 foram investigados. Após a determinação dos critérios de inclusão e exclusão, a população do estudo foi identificada. Foram realizadas medições do teste da vareta da urina e da razão da creatinina das proteínas na urina (UPCR). RESULTADOS: Este estudo transversal descritivo foi realizado com 21 pacientes com COVID-19. A idade média dos pacientes foi de 42,2±8,8 anos e 71,4% dos pacientes eram do sexo masculino. A duração média do seguimento foi de 28,4±9,3 dias. O teste de RT-PCR na urina foi positivo em um paciente (4,8%). Houve melhorias observadas na hematúria em 71,4% e na proteinúria em 85,7% no final do acompanhamento. E uma diminuição significativa na UPCR medida em comparação à linha de base (p=0,000). Além disso, foram registradas melhorias nas contagens sanguíneas completas, nos parâmetros inflamatórios, nos testes de ferritina e de coagulação, comparados aos valores basais. Houve correlação positiva entre UPCR basal e ferritina, e correlação negativa entre os valores basais de UPCR e sódio. CONCLUSÃO: A síndrome nefrítica de novo induzida por COVID-19 pode ocorrer principalmente devido ao envolvimento túbulo-intersticial e frequentemente resulta em remissão espontânea. No entanto, a questão de por que esses achados não se apresentaram em todos os pacientes que não apresentavam condição comórbida não é clara.