Vildagliptin compared to glimepiride on post-prandial lipemia and on insulin resistance in type 2 diabetic patients

Autor: Angela D'Angelo, Elena Fogari, Giuseppe Derosa, Aldo Bonaventura, Pamela Maffioli, Davide Romano, Lucio Bianchi
Rok vydání: 2014
Předmět:
Male
Pyrrolidines
endocrine system diseases
Endocrinology
Diabetes and Metabolism
Adamantane
Weight Gain
chemistry.chemical_compound
Endocrinology
Vildagliptin
Hypolipidemic Agents
biology
Glimepiride
digestive
oral
and skin physiology
Middle Aged
Postprandial Period
Metformin
Intention to Treat Analysis
Diabetes and Metabolism
Combination
Drug Therapy
Combination
Female
Retinol binding
Type 2
medicine.drug
Oral fat load
medicine.medical_specialty
Hyperlipidemias
Insulin resistance
Type 2 diabetes mellitus
Aged
Diabetes Mellitus
Type 2
Dipeptidyl-Peptidase IV Inhibitors
Double-Blind Method
Humans
Hyperglycemia
Hypoglycemia
Hypoglycemic Agents
Nitriles
Sulfonylurea Compounds
Weight Loss
Insulin Resistance
Drug Therapy
Internal medicine
Diabetes Mellitus
medicine
Glycemic
Retinol binding protein 4
business.industry
nutritional and metabolic diseases
medicine.disease
chemistry
biology.protein
Resistin
Glycated hemoglobin
business
Zdroj: Metabolism. 63:957-967
ISSN: 0026-0495
DOI: 10.1016/j.metabol.2014.04.008
Popis: Objectives To evaluate the effects of vildagliptin compared to glimepiride on glycemic control, insulin resistance and post-prandial lipemia. Material and Methods 167 type 2 diabetic patients, not adequately controlled by metformin, were randomized to vildagliptin 50 mg twice a day or glimepiride 2 mg three times a day for 6 months, in a double blind, randomized clinical trial. We evaluated: body mass index (BMI), glycemic control, fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), fasting plasma proinsulin (FPPr), glucagon, lipid profile, resistin, retinol binding protein-4 (RBP-4), visfatin and vaspin. Furthermore, at the randomization and at the end of the study all patients underwent an euglycemic hyperinsulinemic clamp to evaluate M value and an oral fat load. Results Despite a similar decrease of glycated hemoglobin, there were an increase of body weight with glimepiride + metformin and a decrease with vildagliptin + metformin. Fasting plasma insulin increased with glimepiride + metformin, while it did not change with vildagliptin + metformin. Vildagliptin + metformin improved lipid profile. Regarding insulin sensitivity, vildagliptin + metformin increased M value. Resistin, RBP-4, vaspin and visfatin were decreased by vildagliptin + metformin, but in group to group comparison, only vaspin reduction resulted statistically significant. Vildagliptin + metformin reduced post-prandial lipemia and insulinemia compared to glimepiride + metformin. Conclusion Vildagliptin, in addition to metformin, was more effective than glimepiride + metformin in reducing insulin resistance and post-prandial lipemia.
Databáze: OpenAIRE
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