Bernadette Dian Novita Dewi, - (2009) Efek Terapi Kombinasi Metformin - Oksigen Hiperbarik Pada Pasien Diabetes Mellitus Tipe 2: Peningkatan Kadar Endothelial Nitric Oxide Synthase (eNOS) Dan Penurunan Kadar Glukosa Darah. Thesis thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Metformin is the first line drug of type 2 diabetes patients. Its improves Insulin sensitivity as mechanism of action via activation of cyclic-adenomonophosphat dependent protein kinase (AMPK), reduces hepatic glucose product by reducing gluconeogenesis, and increases endothelial Nitric Oxide Synthase (eNOS). Chronic hyperglycemia induces Nitric Oxide (NO) dysfunction, where as, NO is important vasodilator in human body. Due to of NO dysfunction, cells become hypoxia to ischemic then cell apoptotic, included cells ~ pancreatic. The aim of this study to find new management in optimalisation of Metformin therapy in patients with type 2 diabetes, especially in the improvement of blood glucose into 'normoglycemia' and eNOS, the important indicator for vascular condition. Hyperbaric oxygen (HBO), 2.4 AT A. which is given 3x30 minutes with 5 minutes intervals for 10 times within 10 days continually, reduces directly blood glucose, improves NO function and inhibits cytokines released. Therefore, HBO therapy is considered as an adjuvant treatment in type 2 DM beside Metformin. Methods : This study was conducted by a clinical pre and post experiment without control. The ten men's correspondents in the study were chosed randomly. Blood glucose and eNOS concentration are used as the parameters in this study_ They were examined before, during and after the combination treatment of Metformin and HBO were given. All parameters were statistically analyzed by paired t-test. Result : The concentration of eNOS were increased significantly and also with the blood glucose condition, it reduced significantly after the combination treatment of Metformin and HBO. Conclusion : HBO therapy works synergism with Metformin in diabetes type2 therapy, especially by improving Metformin therapy in reduced blood glucose and raised eNOS. It is a new hope to prevent micro and macro angiopathy's complication in patient with chronic hyperglycemia caused by type 2 diabetes

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