No study has ever examined the effect of vitamin C with metformin on fasting (FBS) and postmeal blood glucose (PMBG) as well as glycosylated hemoglobin (HbA1c) in the treatment of type 2 diabetes mellitus (DM). The goal was to examine the effect of oral vitamin C with metformin on FBS, PMBG, HbA1c, and plasma ascorbic acid level (PAA) with type 2 DM. Seventy patients with type 2 DM participated in a prospective, double-blind, placebo-controlled, 12-week study. The patients with type 2 DM were divided randomly into placebo and vitamin C group of 35 each. Both groups received the treatment for twelve weeks. Decreased PAA levels were found in patients with type 2 diabetes mellitus. This level was reversed significantly after treatment with vitamin C along with metformin compared to placebo with metformin. FBS, PMBG, and HbA1c levels showed significant improvement after 12 weeks of treatment with vitamin C. In conclusion, oral supplementation of vitamin C with metformin reverses ascorbic acid levels, reduces FBS, PMBG, and improves HbA1c. Hence, both the drugs in combination may be used in the treatment of type 2 DM to maintain good glycemic control.

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BACKGROUND Chronic renal failure is a progressive decline in renal function with loss of nephrons leading to signs and symptoms of uraemia. CRF affects endocrine systems in multiple ways including abnormal hormone production, metabolism, feedback regulation and altered tissue sensitivity. Thyroid hormones are essential for an adequate growth and development of kidneys; conversely, kidney is not only an organ of metabolism and elimination of thyroid hormones, but also a target of iodothyronine actions. Renal disease leads to significant changes in thyroid function. In CRF, iodide uptake is low due to decreased iodide clearance. Protein loss may alter the binding capacity of hormones and abnormal constituents like urea may blunt the tissue responsiveness to thyroid hormones. The association of different glomerulopathies less frequently tubulointerstitial diseases have been reported with hypo or hyper function of the thyroid. METHODS Patients with chronic kidney disease in Department of Medicine and Nephrology, Down Town Hospital, Guwahati, Assam, were included in the study. Both male and female patients with varying grades of CRF, more than 18 years of age were included in the study. It was cross sectional study. RESULTS Age range in the study varies from 27-87 years. Male patients were 30 accounting for 60% and female patients were 20 accounting for 40%. Creatinine clearance ranges from 3.4 mL/min-32.3 mL/min. Blood urea values varied from 55-257 mg/dL, the mean being 121.04. Serum creatinine levels varied from 1.8-21.16 mg/dL, the mean value being 7.58 mg/dL. The study range of serum T3 was 0.643-2.3 nmol/L, (normal range 1.49-2.60 nmol/L), serum T4 was 37.7-140 nmol/L (normal range 71.2-142 nmol/L) and serum TSH was <0.015->100 micro IU/mL (normal range 0.465-4.68 mIU/mL). In our study 10 patients had low T3 syndrome, 2 patients had low T4 Syndrome, 9 patients had hypothyroidism, 8 patients had subclinical hypothyroidism and 1 patient had hyperthyroidism. CONCLUSIONS In the current study 50 cases with varying grades of chronic renal failure with age >18 years are selected according to inclusion and exclusion criteria as mentioned. The present study is limited in the sense that data comes from a population served in a tertiary healthcare hospital. Therefore, it's not a population-based study. However, the findings of this study will serve to analyse the association between thyroid dysfunction, if any, in chronic renal failure patients.