Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus
| Autor: | Maria Elizabeth Rossi da Silva, H. A. Machado, Marcia Regina Soares Correia, Bernardo Léo Wajchenberg, Rosa Ferreira dos Santos, Silvia G. Lage, Dalva Marreiro Rocha, Marcelo Andrade da Costa Vieira, Rosa Tsunechiro Fukui, M. R. Cunha |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty medicine.medical_treatment Hemostatic factors Type 2 diabetes Metabolic profile Glucagon medicine.artery Internal medicine Diabetes mellitus medicine Humans Hypoglycemic Agents Prospective Studies Brachial artery lcsh:R5-920 business.industry Insulin Type 2 Diabetes Mellitus General Medicine Fasting Organ Size Clinical Science Middle Aged medicine.disease Lipids Metformin Treatment Glimepiride Endocrinology Carotid Arteries Sulfonylurea Compounds Diabetes Mellitus Type 2 Female business lcsh:Medicine (General) Vascular reactivity medicine.drug |
| Zdroj: | Clinics Clinics; v. 67 n. 7 (2012); 711-717 Clinics; Vol. 67 Núm. 7 (2012); 711-717 Clinics; Vol. 67 No. 7 (2012); 711-717 Universidade de São Paulo (USP) instacron:USP Clinics, Vol 67, Iss 7, Pp 711-717 (2012) Clinics, Volume: 67, Issue: 7, Pages: 711-717, Published: JUL 2012 |
| ISSN: | 1980-5322 1807-5932 |
| Popis: | OBJECTIVE: To compare the effects of glimepiride and metformin on vascular reactivity, hemostatic factors and glucose and lipid profiles in patients with type 2 diabetes. METHODS: A prospective study was performed in 16 uncontrolled patients with diabetes previously treated with dietary intervention. The participants were randomized into metformin or glimepiride therapy groups. After four months, the patients were crossed over with no washout period to the alternative treatment for an additional four-month period on similar dosage schedules. The following variables were assessed before and after four months of each treatment: 1) fasting glycemia, insulin, catecholamines, lipid profiles and HbA1 levels; 2) t-PA and PAI-1 (antigen and activity), platelet aggregation and fibrinogen and plasminogen levels; and 3) the flow indices of the carotid and brachial arteries. In addition, at the end of each period, a 12-hour metabolic profile was obtained after fasting and every 2 hours thereafter. RESULTS: Both therapies resulted in similar decreases in fasting glucose, triglyceride and norepinephrine levels, and they increased the fibrinolytic factor plasminogen but decreased t-PA activity. Metformin caused lower insulin and pro-insulin levels and higher glucagon levels and increased systolic carotid diameter and blood flow. Neither metformin nor glimepiride affected endothelial-dependent or endothelial-independent vasodilation of the brachial artery. CONCLUSIONS: Glimepiride and metformin were effective in improving glucose and lipid profiles and norepinephrine levels. Metformin afforded more protection against macrovascular diabetes complications, increased systolic carotid artery diameter and total and systolic blood flow, and decreased insulin levels. As both therapies increased plasminogen levels but reduced t-PA activity, a coagulation process was likely still ongoing. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|