Thesis

An open-label, uncontrolled study to evaluate the effect of verapamil on glycaemic control in type 2 diabetes mellitus patients with hypertension

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Awarding institution
  • University of Strathclyde
Date of award
  • 2022
Thesis identifier
  • T16394
Person Identifier (Local)
  • 201559491
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Abstract
  • Introduction: Type 2 diabetes is a common chronic disease that continues to globally increase in prevalence and is a major healthcare burden. Diabetes and hypertension are frequently coexistent conditions and the use of antihypertensive agents is common in diabetic patients. One antihypertensive agent, verapamil, had tentatively shown potentially positive effects on glycaemic control in assorted pre-clinical models. Aim: To evaluate the effect of verapamil on glycaemic control in hypertensive type 2 diabetic patients. Method: Type 2 diabetic hypertensive subjects were recruited from King Fahad Medical City, Riyadh, KSA to receive oral verapamil therapy. Blood pressure and glucometabolic parameters including fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), C-peptide, and Homeostatic Model Assessment Insulin Resistance (HOMA-IR) were monitored at baseline and after 6 months of verapamil therapy. Results: 35 patients (16 male, 19 female) with a mean age of 57.2 years were recruited. The use of verapamil was associated with non-significant decreases in HbA1c (0.2 ± 1.0%, P=0.25%), FPG (0.5 ± 1.8 mmol/L, P=0.11), C-peptide (0.1 ± 0.3 nmol/L, P=0.06), and HOMA-IR (0.3 ± 0.9, P=0.05).. However a sub-group of 17 participants had a decrease in HbA1c that was ≥ 0.5%. Univariable logistic regression showed that baseline BMI, HOMA-IR, and C-peptide (P<0.05) were significantly associated with HbA1c reductions of ≥ 0.5%. HbA1c levels were affected by sitagliptin use, metformin dose, insulin use, duration of diabetes, neuropathy, and retinopathy (P<0.05). Additionally, insulin use was negatively associated with FPG levels but had no association with HOMA-IR and C-peptide levels (P<0.05). Conclusion: Verapamil was metabolically neutral and allowed stabilization of glycometabolic parameters in type 2 diabetic individuals. Additional research exploring why there was variable response to verapamil therapy is warranted.
Advisor / supervisor
  • Mullen, Alexander
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