TY - JOUR
T1 - Effects of a combination of sitagliptin plus metformin vs metformin monotherapy on glycemic control, β-cell function and insulin resistance in type 2 diabetic patients
AU - Derosa, Giuseppe
AU - Carbone, Anna
AU - Franzetti, Ivano
AU - Querci, Fabrizio
AU - Fogari, Elena
AU - Bianchi, Lucio
AU - Bonaventura, Aldo
AU - Romano, Davide
AU - Cicero, Arrigo F G
AU - Maffioli, Pamela
PY - 2012/10
Y1 - 2012/10
N2 - Aims: To evaluate the impact on glycemic control, insulin resistance, and insulin secretion of sitagliptin. +. metformin compared to metformin in type 2 diabetic patients. Methods: Patients were instructed to take metformin for 8 ± 2 months, then they were randomly assigned to sitaglipin 100. mg or placebo for 12 months. We evaluated at 3, 6, 9, and 12 months: body mass index (BMI), glycemic control, fasting plasma insulin (FPI), HOMA-IR, HOMA-β, fasting plasma proinsulin (FPPr), proinsulin/fasting plasma insulin ratio (Pr/FPI ratio), C-peptide, glucagon, adiponectin (ADN), and high sensitivity-C reactive protein (Hs-CRP). Before, and after 12 months since the addition of sitagliptin, patients underwent a combined euglycemic hyperinsulinemic and hyperglycemic clamp, with subsequent arginine stimulation. Results: Both treatments similarly decreased body weight, and BMI; on the other hand, they both improved glycemic control, glucagon and HOMA-IR, but sitagliptin. +. metformin were more effective in reducing these parameters. Sitagliptin. +. metformin, but not placebo. +. metformin, decreased FPPr, FPPR/FPI ratio, and increased C-peptide values, even if no differences between the groups were recorded. Sitaglitin. +. metformin gave also a greater increase of HOMA-β, M value, C-peptide response to arginine and disposition index compared to placebo. +. metformin group. Conclusions: Other than improving glycemic control, sitagliptin. +. metformin also improved β-cell function better than metformin alone.
AB - Aims: To evaluate the impact on glycemic control, insulin resistance, and insulin secretion of sitagliptin. +. metformin compared to metformin in type 2 diabetic patients. Methods: Patients were instructed to take metformin for 8 ± 2 months, then they were randomly assigned to sitaglipin 100. mg or placebo for 12 months. We evaluated at 3, 6, 9, and 12 months: body mass index (BMI), glycemic control, fasting plasma insulin (FPI), HOMA-IR, HOMA-β, fasting plasma proinsulin (FPPr), proinsulin/fasting plasma insulin ratio (Pr/FPI ratio), C-peptide, glucagon, adiponectin (ADN), and high sensitivity-C reactive protein (Hs-CRP). Before, and after 12 months since the addition of sitagliptin, patients underwent a combined euglycemic hyperinsulinemic and hyperglycemic clamp, with subsequent arginine stimulation. Results: Both treatments similarly decreased body weight, and BMI; on the other hand, they both improved glycemic control, glucagon and HOMA-IR, but sitagliptin. +. metformin were more effective in reducing these parameters. Sitagliptin. +. metformin, but not placebo. +. metformin, decreased FPPr, FPPR/FPI ratio, and increased C-peptide values, even if no differences between the groups were recorded. Sitaglitin. +. metformin gave also a greater increase of HOMA-β, M value, C-peptide response to arginine and disposition index compared to placebo. +. metformin group. Conclusions: Other than improving glycemic control, sitagliptin. +. metformin also improved β-cell function better than metformin alone.
KW - Clamp
KW - HOMA-β
KW - Inflammation
KW - Insulin resistance
KW - Metformin
KW - Sitagliptin
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U2 - 10.1016/j.diabres.2012.05.022
DO - 10.1016/j.diabres.2012.05.022
M3 - Article
C2 - 22682949
AN - SCOPUS:84867400778
VL - 98
SP - 51
EP - 60
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
SN - 0168-8227
IS - 1
ER -