| Autor: |
Tan, M. H., Johns, D., Strand, J., Halse, J., Madsbad, S., Eriksson, J. W., Clausen, J., Konkoy, C. S., Herz, M. |
| Předmět: |
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| Zdroj: |
Diabetic Medicine; Aug2004, Vol. 21 Issue 8, p859-866, 8p |
| Abstrakt: |
This study compared the effects of 52 weeks’ treatment with pioglitazone, a thiazolidinedione that reduces insulin resistance, and glibenclamide, on insulin sensitivity, glycaemic control, and lipids in patients with Type 2 diabetes. Patients with Type 2 diabetes were randomized to receive either pioglitazone (initially 30 mg QD, n = 91) or micronized glibenclamide (initially 1.75 mg QD, n = 109) as monotherapy. Doses were titrated (to 45 mg for pioglitazone and 10.5 mg for glibenclamide) to achieve glycaemic targets during the next 12 weeks: fasting blood glucose of ≤ 7 mmol/l and 1-h postprandial blood glucose of ≤ 10 mmol/l. Patients were maintained on the titrated dose for 40 weeks. Pioglitazone significantly increased insulin sensitivity compared with glibenclamide, as assessed by homeostasis model assessment (17.0% vs. −13.0%; P < 0.001), quantitative insulin sensitivity check index (0.011 vs. −0.007; P < 0.001) and fasting serum insulin (−1.3 pmol/l vs. 23.8 pmol/l; P = 0.007). The glibenclamide group had significantly lower HbA1c than the pioglitazone group after 12 weeks of therapy (7.8% vs. 8.3%, P = 0.015), but significantly higher HbA1c after 52 weeks of therapy (7.8% vs. 7.2%, P = 0.001). Pioglitazone significantly (vs. glibenclamide) increased mean HDL-C ( P < 0.001), decreased mean triglycerides ( P = 0.019), and decreased mean atherogenic index of plasma (AIP; P = 0.001) and mean total cholesterol/HDL-C ( P = 0.004), without significantly elevating mean total cholesterol or mean LDL-C compared with glibenclamide. These data suggest that the effects of pioglitazone are more sustained than those of glibenclamide for improving insulin sensitivity in patients with Type 2 diabetes, and that 52 weeks’ treatment with pioglitazone has favourable effects on glycaemic control and lipoprotein profile. Diabet. Med. (2004) [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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