Effects of one year treatment of vildagliptin added to pioglitazone or glimepiride in poorly controlled type 2 diabetic patients.

Abstract

The aim of the study was to compare the effects of vildagliptin added to pioglitazone or glimepiride on metabolic and insulin resistance related-indices in poorly controlled type 2 diabetic patients (T2DM). 168 patients with T2DM were randomized to take either pioglitazone 30 mg once a day plus vildagliptin 50 mg twice a day or glimepiride 2 mg 3 times a day plus vildagliptin 50 mg twice a day. We evaluated body weight, body mass index (BMI), glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), homeostasis model assessment beta-cell function index (HOMA-beta), fasting plasma proinsulin (FPPr), proinsulin/fasting plasma insulin ratio (Pr/FPI ratio), adiponectin (ADN), resistin (R), tumor necrosis factor-alpha (TNF-alpha), and high sensitivity C-reactive protein (Hs-CRP) at their baseline values, and after 3, 6, 9, and 12 months of treatment. We observed a similar improvement of HbA1c, FPG, PPG, and Hs-CRP compared to baseline in the 2 groups. Fasting plasma insulin, FPPr, Pr/FPI ratio, R, and TNF-alpha were significantly decreased and ADN was significantly increased with pioglitazone plus vildagliptin, but not with glimepiride plus vildagliptin. HOMA-IR, and HOMA-beta values obtained with pioglitazone plus vildagliptin were significantly better than the values obtained with glimepiride plus vildagliptin. Pioglitazone plus vildagliptin were found to be more effective in preserving beta-cell function, and in reducing insulin resistance, and inflammatory state parameters.

• Authors: G Derosa, P Maffioli, I Ferrari, R Mereu, P D Ragonesi, F Querci, I G Franzetti, G Gadaleta, L Ciccarelli, M N Piccinni, A D'Angelo, S A T Salvadeo
• Journal: Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme (Horm Metab Res) Vol. 42 Issue 9 Pg. 663-9 (Aug 2010) ISSN: 1439-4286 [Electronic] Germany
• PMID: 20560108 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright Georg Thieme Verlag KG Stuttgart New York.

Chemical References

• Hypoglycemic Agents
• Nitriles
• Pyrrolidines
• Sulfonylurea Compounds
• Thiazolidinediones
• Tumor Necrosis Factor-alpha
• glimepiride
• Vildagliptin
• Adamantane
• Pioglitazone

Topics

• Adamantane (analogs & derivatives, therapeutic use)
• Body Mass Index
• Body Weight (drug effects)
• Diabetes Mellitus, Type 2 (complications, drug therapy)
• Drug Therapy, Combination
• Female
• Humans
• Hypoglycemic Agents (pharmacology, therapeutic use)
• Inflammation (complications, pathology)
• Insulin Resistance
• Insulin-Secreting Cells (drug effects, metabolism, pathology)
• Male
• Middle Aged
• Nitriles (therapeutic use)
• Pioglitazone
• Pyrrolidines (therapeutic use)
• Sulfonylurea Compounds (pharmacology, therapeutic use)
• Thiazolidinediones (pharmacology, therapeutic use)
• Time Factors
• Treatment Outcome
• Tumor Necrosis Factor-alpha (metabolism)
• Vildagliptin