Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Comparison of metformin versus other treatment modalities in gestational diabetes mellitus(Society for Advance Healthcare Research, Maharashtra, India, 2016) Ekanayake, C.D.; Wijesinghe, P.S.; Herath, R.; Puliyadda, N.; Nishad, N.INTRODUCTION: Despite evidence to prove both its efficacy and safety, use of metformin is at most restricted to only as an adjunct to insulin preparations. We compared the maternal, fetal and neonatal outcomes associated with GDM in women treated with metformin versus those treated with diet alone and diet plus insulin. Method: An observational study was carried out over a period of six months in 104 GDM patients. Study groups were 43 patients on diet alone (group A), 42 on metformin plus diet (group B), and 19 on diet plus insulin (group C). Maternal, fetal and neonatal outcomes were compared. Results: Fourteen patients in group B subsequently required supplemental insulin. Gestational hypertension 5(12%), 4(10%), 5(26%) (p=0.8) and wound infection among 2(5%), 1(2%), 0(0%) (p=0.6) were seen in groups A, B and C respectively. Four patients with polyhydramnios were seen in group B. Mean birth weights were A=3.07kg, B=3.07kg, C=3.1kg (p=0.96). Macrosomia 5 (12%), 3 (7%), 3 (16%) (p=0.2), neonatal hypoglycemia 2 (5%), 2 (5%), 2 (11%) (p=0.4), five minute Apgar scores 9.9, 9.7, 9.9, and neonatal jaundice 5(12%), 4(10%), 3(16%) (p=0.04) were noted in in groups A, B and C respectively. Single case of respiratory distress was seen in the insulin group. Shoulder dystocia and perinatal deaths were not observed. Conclusion: Maternal and perinatal outcomes were similar among diet alone, diet plus metformin, and diet plus insulin groups. Cost-effectiveness, easy administration, safety profile and convenience of storage would make metformin an attractive option in the management of gestational diabetes mellitus.Item Hypoglycaemic and Hypolipidaemic effect of an ethylacetate fraction of Artocarpus heterophyllus (jak) leaves in streptozotocin induced diabetic rats(Sri Lanka Association for the Advancement of Science, 2009) Chackrewarthy, S.; Jayasekera, S.; Thabrew, M.I.; Weerasooriya, M.K.B.Previous investigations have shown that aqueous extracts of Artocarpus heterophyllus (jak) leaves (family Moraceae) can exert significant hypoglycaemic activity, and improve the glucose tolerance of healthy rats and humans, and newly diagnosed maturity onset diabetic patients. A preliminary study carried out by the authors with fractions separated from A. heterophyllus leaves showed that the ethylacetate fraction exerts the greatest hypoglycaemic activity in rats. The objective of the present study was to determine the effects of prolonged administration of ethylacetate fraction of A. heterophyllus leaves on serum glucose and lipid levels in streptozotocin induced diabetic rats since no reports are available on the effects of A. heterophyllus leaves on hyperlipidaemia associated with diabetes despite its clinical significance. Oral administration of the ethylacetate fraction (20 mg kg -1 bw) of A. heterophyllus leaves daily for five weeks significantly lowered serum glucose, cholesterol and triglyceride levels in streptozotocin induced diabetic rats. Compared to the control diabetic rats, the extract treated rats had 39% less serum glucose, 23% lower serum total cholesterol and 40% lower serum triglyceride levels and 11% higher body weight at the end of the fifth week. The percentage reductions in the serum parameters mediated by the test fraction were comparable with those produced by glibenclamide (57%, 32% and 42% reductions in serum glucose, cholesterol and triglycerides, respectively). The stimulation of insulin release by active principles in the ethylacetate fraction may be one of the mechanisms by which this fraction mediates its hypoglycaemic effect. It may be concluded that the ethylacetate fraction of A. heterophyllus leaves contain one or more hypoglycaemic and hypolipidaemic principles which have the potential to be developed further for the treatment of diabetes specifically associated with a hyperlipidaemic state.