Metformin Plus Low-Dose Glimeperide Significantly Improves Homeostasis Model Assessment for Insulin Resistance (HOMAIR) and β-Cell Function (HOMAβ-cell) Without Hyperinsulinemia in Patients With Type 2 Diabetes Mellitus
| Autor: | Freddy Contreras, Valmore Bermúdez-Pirela, Aida Souki, Clímaco Cano, Hamid Seyfi, Manuel Valasco, Miguel A Lemus, Ana Ciscek, Fernando Bermúdez-Arias, Zafar H Israili, Raquel Cano, Elliuz Leal, M. Medina, Rafael Hernández-Hernández |
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| Rok vydání: | 2007 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty endocrine system diseases Type 2 diabetes Motor Activity Models Biological Insulin resistance Hyperinsulinism Insulin-Secreting Cells Diabetes mellitus Internal medicine medicine Hyperinsulinemia Humans Hypoglycemic Agents Insulin Pharmacology (medical) Glycated Hemoglobin Pharmacology business.industry nutritional and metabolic diseases Type 2 Diabetes Mellitus General Medicine Middle Aged medicine.disease Metformin Diet Glimepiride Sulfonylurea Compounds Endocrinology Diabetes Mellitus Type 2 Drug Therapy Combination Female Insulin Resistance Beta cell business medicine.drug |
| Zdroj: | American Journal of Therapeutics. 14:194-202 |
| ISSN: | 1075-2765 |
| DOI: | 10.1097/01.pap.0000249909.54047.0e |
| Popis: | OBJECTIVE Type 2 diabetes mellitus is characterized by insulin resistance and defects in insulin secretion from pancreatic beta-cells, which have been studied by using euglycemic/hyperinsulinemic clamps. However, it is difficult to study insulin resistance and beta-cell failure by these techniques in humans. Therefore, the aim of this study was to evaluate the effect of three different antidiabetic therapeutic regimens on insulin resistance and beta-cell activity by using a mathematical model, Homeostasis Model Assessment for insulin resistance (HOMA(IR)) and beta-cell function (HOMA(beta-cell)). RESEARCH DESIGN AND METHODS Seventy type 2 diabetic patients were randomly assigned to one of three therapeutic regimens: (A) metformin + American Diabetic Association (ADA)-recommended diet + physical activity; (B) metformin + low-dose glimepiride + ADA diet + physical activity; or (C) ADA diet + physical activity (no drugs). Blood samples were obtained before and after the treatment to determine serum levels of fasting and post-prandial blood glucose, fasting insulin, and glycosylated hemoglobin (HbA1c), and HOMA(IR) and HOMA(beta-cell) were calculated. RESULTS Fasting and post-prandial levels of glucose, HbA1c, and fasting insulin and calculated HOMA(IR) and HOMA(beta-cell) values before treatment were significantly higher than the respective values after treatment for all groups of patients (P < 0.01). Significant differences were also found when comparing the treatment-induced reduction in fasting blood glucose (51.8%; P < 0.01), post-prandial blood glucose (55.0%; P < 0.05), and HOMA(IR) (65.3%; P < 0.01) in patients of Group B with that in patients receiving other therapeutic options (Groups A and C). CONCLUSIONS Metformin plus low-dose glimepiride (plus ADA diet and physical activity) is a more effective treatment for type 2 diabetes than either metformin plus ADA diet and physical activity or ADA diet and physical activity alone. Determination of HOMA(IR) and HOMA(beta-cell) values is an inexpensive, reliable, less invasive, and less labor-intensive method than other tests to estimate insulin resistance and beta-cell function in patients with type 2 diabetes mellitus. |
| Databáze: | OpenAIRE |
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