Endocrine Abstracts

Introduction: Type 2 diabetes mellitus (T2DM) poses a significant challenge when optimal oral therapies fail to achieve adequate glycemic control. This study explores the potential of cholestyramine, a bile acid sequestrant traditionally used for lowering cholesterol, as auxiliary therapy for patients with T2DM on maximized oral medication regimens. Despite the effectiveness of various oral medications, some individuals with T2DM experience persistent hyperglycemia. Cholestyramine’s mechanism of action in T2DM management is not fully elucidated. While its primary function is to bind bile acids in the intestine, potentially improving glp1 secretion, more research research is needed to understand the specific pathways involved in glycemic control.

Materials and Methods: This retrospective cohort study followed 200 patients with poorly controlled type 2 diabetes in a private clinic. All participants were on maximized oral therapy with HbA1c levels exceeding 8.6%. One hundred patients (Group 1) received cholestyramine 4 grams daily for hypercholesterolemia alongside their existing treatment regimen, which included metformin XR 2 grams daily, sitagliptin 100 mg daily, empagliflozin 25 mg daily, and pioglitazone 30 mg daily. The remaining 100 patients continued on maximized oral therapy alone.

Results: Findings demonstrate a statistically significant decrease in HbA1c levels (P < 0.0001) within group 1 patients following 3 months of cholestyramine treatment. Conversely, group 2 displayed no significant change in HbA1c (P < 0.7750). The results show that cholestyramine 4 gm once daily can lead to control of blood glucose in difficult to control type 2 diabetes patients.

Conclusion: This review investigates the possibility of cholestyramine as an additional treatment option for individuals with T2DM struggling to achieve glycemic control despite optimized oral therapies. By analyzing existing research and highlighting areas for further investigation, this review aims to contribute to the ongoing exploration of novel therapeutic approaches in T2DM management.