A comparison of the effects of pioglitazone and rosiglitazone combined with glimepiride on prothrombotic state in type 2 diabetic patients with the metabolic syndrome

Giuseppe Derosa, Arrigo F G Cicero, Antonio Gaddi, Pietro D. Ragonesi, Mario N. Piccinni, Elena Fogari, Sibilla Salvadeo, Leonardina Ciccarelli, Roberto Fogari

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To compare the effects of glimepiride plus pioglitazone or plus rosiglitazone in diabetic patients with the metabolic syndrome on coagulation and fibrinolysis parameters. Study design and methods: 91 type 2 diabetic patients with the metabolic syndrome participated. All patients took a fixed dose of glimepiride, 4 mg/day. We administered pioglitazone (15 mg/day) or rosiglitazone (4 mg/day) in a randomized, controlled, double-blind clinical study. We compared body mass index (BMI), glycemic control, coagulation and fibrinolysis parameters, and heart rate (HR) during 12 months of this treatment. Results: A total of 87 completed the study (pioglitazone n = 45 or rosiglitazone n = 42). Body mass index increased after 12 months compared to baseline (p <0.05) in both groups. A significant decrease in glycated haemoglobin (HbA1c) was observed after 9 (p <0.05), and 12 (p <0.01) months in both groups. After 9 and 12 months, mean fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels were lower in both groups (p <0.05 and 0.01, respectively), as were fasting plasma insulin (FPI) and postprandial plasma insulin (PPI) (p <0.05 and p <0.01, respectively). An improvement in the homeostasis model assessment index (HOMA index) was seen at 9 and 12 months (p <0.05 and 0.01, respectively) compared to the baseline value in both groups. Plasminogen activator inhibitor 1 (PAI-1) was significant lower (p <0.05) in both groups after 12 months compared to the baseline values. No changes in tissue-plasminogen activator (t-PA) and fibrinogen (Fg) were seen during the study nor were there any changes in transaminases. Conclusions: We conclude that the addition of a thiazolinedione to glimepiride treatment in type 2 diabetic subjects with the metabolic syndrome is associated with a slight but significant reduction of PAI-1 value, related to a similar reduction in insulinresistance.

Original languageEnglish
Pages (from-to)5-13
Number of pages9
JournalDiabetes Research and Clinical Practice
Volume69
Issue number1
DOIs
Publication statusPublished - Jul 2005

Keywords

  • Fibrinolysis
  • Glimepiride
  • Metabolic syndrome
  • Pioglitazone
  • Rosiglitazone

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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