Abstract

Background: There is a need for new oral antidiabetic agents with different modes of action. Moving away from conventional “Triumvirate,” most important player implicated in the pathogenesis of type 2 diabetes is the brain, which along with seven other companions form the “ominous octet.” Bromocriptine mesylate is one such drug which acts on brain, upregulating dopaminergic tone thereby reducing insulin resistance and improving glucose tolerance.

Objectives: To study the efficacy of bromocriptine mesylate as an add-on therapy in patients with T2DM inadequately controlled on two oral antidiabetic drugs.

Materials and Methods: A total of 50 patients according to inclusion and exclusion criteria formed the subject matter of this prospective, non-randomized study. Bromocriptine mesylate was added in weekly 0.8 mg increments to achieve a target dose between 1.6 and 4.8 mg depending on the patient tolerance. Baseline measurements of fasting blood sugar (FBS), postprandial blood sugar (PPBS), and glycosylated hemoglobin (HbA1c) were followed up at 6 and 12 weeks. Appropriate history, examination and laboratory tests were done at each visit to identify any adverse effects. Paired Student’s t-test was used for analysis using SPSS 17 statistical software.

Results: Baseline mean FBS, PPBS, and HbA1c values were 146.86 mg/dL, 227.92 mg/dL, and 8.66%, respectively. After 6 weeks of bromocriptine mesylate add-on therapy, FBS, PPBS and HbA1c showed a mean fall of 19.96 mg/dL, 45.90 mg/dL, and 0.85%, respectively, which was found to be statistically significant (P < 0.05). After 12 weeks of therapy, FBS, PPBS, and HbA1c showed a mean fall of 34.24 mg/dL, 60.36 mg/dL, and 1.56%, respectively, when compared with baseline values, was found to be statistically significant (P < 0.05).

Conclusion: Patients showed a significant reduction in fasting, PPBS and HbA1c levels both at 6 and 12 weeks without any significant adverse effects. Reduction in HbA1c was more in diabetics with poor baseline glycemic control compared to those having fair and good control. Bromocriptine mesylate is an effective antidiabetic drug which when added on to existing oral antidiabetic therapy in uncontrolled diabetes helps achieve optimal glycemic control.

Key words: Diabetes Mellitus; Glycosylated Hemoglobin A; Insulin Resistance; Dopamine Agonists; Bromocriptine