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Background: Type 2 Diabetes Mellitus is an emerging pandemic with number of patients increasing rapidly in both developed and developing nations. In patients with secondary failure of type 2 diabetes after oral hypoglycaemic agents (OHAs), Insulin is the treatment, which is available in various forms with respect to viable duration of action. Basal Insulins or background insulins are used commonly either alone or with short acting insulins. NPH insulin is intermediate acting insulin given once or twice daily whereas Glargine is long acting insulin given once daily. Methods: In this study, 120 patients of type 2 diabetes mellitus already on oral hypoglycaemic agents who were not optimally controlled with combination of 2 or 3 oral hypoglycaemic agents were included after excluding patients of Type 1 diabetes, gestational diabetes and those who were newly diagnosed or already on insulin therapy. Patients were divided into 2 groups of 60 patients each. Group A were put on NPH insulin and Group B on Glargine insulin for 12 weeks. Along with parameters of diabetes and side effects were compared with special reference to early morning hypoglycaemia (at 3 am).Results: Mean reduction in fasting blood glucose was 54.42 mg/dl in Group A as compared to 66.62 mg/dl in Group B, which was statistically significant with a p value < 0.0001. Regarding hypoglycaemia it was seen in 31.67% in Group A vs. 11.67% in Group B and was significant (p=0.0078). Nocturnal hypoglycaemia was also seen to be more in Group A than Group B with values of 21.67% and 5% respectively, which was significant. There was no significant difference in daily dose requirement. Conclusion: This study showed that Insulin Glargine was better than Insulin NPH in terms of glycemic control and less side effects with respect to hypoglycemic events and nocturnal hypoglycemia with no significant difference in daily dose requirements.

Background: Diabetes mellitus is chronic, metabolic disease characterized by hyperglycemia, which over time causes both microvascular and macrovascular complications. If HbA1c target is not achieved with dual therapy then 3rd drug is added. Aims of present study were to compare efficacy and safety of Hydroxychloroquine (HCQ) and Teneligliptin in patients of T2DM who are refractory to concomitant Metformin and Glimepiride. Methods: It was interventional, randomized, prospective, parallel and open-label study. Patients were randomly divided into 2 groups either HCQ 400mg OD or Teneligliptin 20mg OD were added to their current treatment using Metformin 1gm BD and Glimepiride 4 mg OD as 3rd drug. Follow up was done every 15 days for 12 weeks and underwent assessment of glycaemic parameters (FBS, PPG, HbA1c), LFT, RFT, CBC, ADRs and VAS in addition to anthropometric parameters. Results: After 12 weeks of treatment, HCQ group showed statistically (p<0.05) better improvement in BMI than Teneligliptin group. Both groups showed comparable improvement (p>0.05) from baseline in FBS, HbA1c, PPG and VAS score. In HCQ group there was significant number (p<0.05) of patients who achieved target glycaemic control (HbA1c ≤7.5%) i.e., 56.6%, compared to 37% with Teneligliptin group. Both groups had comparable (p>0.05) safety profile with no serious adverse effects and no significant change (p>0.05) in hepatic, renal and complete blood profiles. Conclusions: On the basis of effects of HCQ on the glycaemic parameters and BMI, HCQ may be preferred over Teneligliptin in patients of T2DM who are refractory to concomitant Metformin and Glimepiride.

Background and Objectives: NAFLD and T2DM has global prevalence of 55.5% with currently no approved treatment. There is insufcient data for its pharmacotherapy. The sharing of risk factors, most common being the insulin resistance between NAFLD and T2DM, makes the antidiabetic drugs, with effect on insulin resistance, the potential treatment options. The aim was to compare efcacy and safety of antidiabetic drugs i.e. Metformin and Glimepiride with concomitant Rosuvastatin in NAFLD coexistent with T2DM. Methods: Randomized, prospective, parallel and open-label study recruited 60 patients of concomitant NAFLD and T2DM after getting Institutional Review Board approval. Patients of either sex (20-60 years) with NAFLD (ultrasound diagnosed & raised AST 50-150 U/L) and T2DM(FBS> 126mg/dl) were recruited in medicine OPD after obtaining written informed consent. Chronic alcohol users and pregnancy cases were excluded. Patients were randomised into Group A[Rosuvastatin(10mg OD)+ Metformin(1gm BD)] & Group B[Rosuvastatin(10mg OD)+Glimepiride(3mg BD)]. Primary outcome was improvement in hepatic parameters and ultrasound grading of liver. Secondary outcomes were improvement in anthropometric, glycaemic and lipid parameters and assessment of safety. Results: Group A caused signicant(p<0.05) reduction in hepatic parameters(S.Bilirubin & AST). Group A and B showed non-signicant improvement(p>0.05) in ultrasound grading of liver, respectively (24% vs 20% patients). Intergroup difference was signicant(p<0.05) for weight and BMI in Group A. Both groups showed highly signicant(p<0.001) reduction in glycaemic parameters and signicant(p<0.05) reduction in lipid parameters. Both treatments were safe. Conclusion: Metformin plus Rosuvastatin seems to be more efcacious in NAFLD and T2DM over 90 days. These drugs could improve prognosis because of insulin sensitising action and additional benets in cancers, cardiovascular diseases. Further studies are required to strengthen these ndings which may help in nding a standard treatment for NAFLD and T2DM.