Abstract

Background: Oxidative stress may contribute to the pathogenesis of diabetes mellitus, and hyperglycemia and oxidative stress can reinforce each other. The use of antioxidant drugs, therefore, may be beneficial in treatment of diabetes mellitus and paracetamol had been shown to have antioxidant activity.
Objectives: To evaluate the potential role of paracetamol in type-2 diabetic patients not achieving target glycated hemoglobin (HbA1c).
Patients and Methods: Twenty four type-2 diabetic patients consulting the Center for Diabetes and Endocrinology in Maysan were included in this study after meeting a set of inclusion criteria. Their HbA1c was more than 7% despite the continuous use of oral antihyperglycemic drugs. Patients were treated with paracetamol 1000mg tablet once daily for one month. Blood samples were taken before, one month and three months after the start of treatments for measurement of HbA1c, C-reactive protein, C-peptide level, total antioxidant capacity and more frequently plasma glucose level (fasting/random). Another sixty patients of similar inclusion criteria were also followed for three months but without treatment with paracetamol and served as a control group.
Results: One month treatment with paracetamol (n=24) resulted in a beneficial effect particularly when measured two months after cessation of paracetamol treatment. Paracetamol significantly reduced HbA1c by 7.32% and random plasma glucose (RBG) by 22%, and greatly increased C-peptide by 443%. Total antioxidant capacity measured once after one month of paracetamol treatment increased by 20.2%. Unexpectedly, CRP was reduced significantly by 63.9%. The control, non- intervention group did not show significant changes in the levels of HbA1c over the three month period. Measurement of HOMA- ß C-peptide in a limited number of patients indicate that paracetamol significantly improve ß-cell function.
Conclusion: Paracetamol 1000mg tablet, when administered once daily for one month seem to be effective in achieving a good glycemic control in patients not achieving target HbA1c.