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

Giuseppe Derosa, Anna Carbone, Ivano Franzetti, Fabrizio Querci, Elena Fogari, Lucio Bianchi, Aldo Bonaventura, Davide Romano, Arrigo F G Cicero, Pamela Maffioli

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)51-60
Number of pages10
JournalDiabetes Research and Clinical Practice
Volume98
Issue number1
DOIs
Publication statusPublished - Oct 2012

Fingerprint

Metformin
Insulin Resistance
Fasting
Proinsulin
C-Peptide
Insulin
Placebos
Glucagon
Arginine
Body Mass Index
Sitagliptin Phosphate
Adiponectin
C-Reactive Protein
Body Weight

Keywords

  • Clamp
  • HOMA-β
  • Inflammation
  • Insulin resistance
  • Metformin
  • Sitagliptin

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Endocrinology

Cite this

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. / Derosa, Giuseppe; Carbone, Anna; Franzetti, Ivano; Querci, Fabrizio; Fogari, Elena; Bianchi, Lucio; Bonaventura, Aldo; Romano, Davide; Cicero, Arrigo F G; Maffioli, Pamela.

In: Diabetes Research and Clinical Practice, Vol. 98, No. 1, 10.2012, p. 51-60.

Research output: Contribution to journalArticle

Derosa, Giuseppe ; Carbone, Anna ; Franzetti, Ivano ; Querci, Fabrizio ; Fogari, Elena ; Bianchi, Lucio ; Bonaventura, Aldo ; Romano, Davide ; Cicero, Arrigo F G ; Maffioli, Pamela. / 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. In: Diabetes Research and Clinical Practice. 2012 ; Vol. 98, No. 1. pp. 51-60.
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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

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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

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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.

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KW - Metformin

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