Author(s): Mahmood A. Al-Hafidh Khattab1 and Wahda Basheer Al-Youzbaki2*
Background: It has been hypothesized that serum ferritin could be a marker of insulin resistance and that serum ferritin may also be an independent determinant of poor metabolic control in the diabetic patient. Objective: To evaluate the effect of metformin on the relationship between serum ferritin and glycemic control and insulin resistance in type 2 diabetes mellitus (T2DM) patients. Methodology: This is a case control study conducted from the period of the 15th of April 2013 to the 31st of December 2013 on 100 patients with T2DM, their age range was between (40-70) years. They were divided into two groups, the 1st group consisted of fifty T2DM (24 males and 26 females), , treated by metformin tablets only, in doses ranged from 500-1700 mg/day. Group 2 consisted of fifty newly diagnosed T2DM on diet for 1-3 months (22 males and 28 females). Forty nine apparently healthy subjects (29 males and 20 females), also their age range was between (40-70) years, were included in this study as a control group. Part of the whole blood sample which was obtained after overnight fasting from the three groups was used to measure HbA1C and the sera from the remaining blood samples were used to measure fasting serum glucose (FSG), serum ferritin and insulin by commercial kits while HOMA-IR was calculated by special equation. Results: This study demonstrated a significant higher level of the mean serum ferritin and Hb in the male diabetic group on diet and the male diabetic group on metformin in comparison with the male healthy control group, but a non significant differences in the mean serum ferritin and Hb level in the two male diabetic groups. There were a significant higher mean serum ferritin level but a non significant difference in the mean Hb level of the female diabetic on diet group and the female diabetic group on metformin in comparison with female healthy control group, but a non significant differences in the mean serum ferritin and Hb level in the two female diabetic groups. This study showed a significant higher level of the mean FSG and HbA1c level in the diabetic on diet group and the diabetic on metformin group in comparison with healthy control group, but a significant lower level of the mean FSG and a non-significant lower level of HbA1c in the diabetic on metformin group in comparison with diabetic on diet group. There were a significant lower level of mean serum insulin and HOMA-IR value in the diabetic on metformin group in comparison with diabetic on diet group. Conclusion: There were non-significant differences between mean serum ferritin level in diabetic on metformin in comparison with diabetic on diet in male and female patients. Metformin for more than six months caused a significant glycemic control, and a significant reduction in insulin resistance in comparison with diabetic on diet groups, but there were no significant correlation between mean serum ferritin level and glycemic control, nor with insulin resistance parameters.