Effects of one year treatment of vildagliptin added to pioglitazone or glimepiride in poorly controlled type 2 diabetic patients

G. Derosa, P. Maffioli, I. Ferrari, R. Mereu, P. D. Ragonesi, F. Querci, I. G. Franzetti, G. Gadaleta, L. Ciccarelli, M. N. Piccinni, A. Dangelo, S. A T Salvadeo

Research output: Contribution to journalArticlepeer-review

Abstract

The aim of the study was to compare the effects of vildagliptin added to pioglitazone or glimepiride on metabolic and insulin resistance related-indices in poorly controlled type 2 diabetic patients (T2DM). 168 patients with T2DM were randomized to take either pioglitazone 30mg once a day plus vildagliptin 50mg twice a day or glimepiride 2mg 3 times a day plus vildagliptin 50mg twice a day. We evaluated body weight, body mass index (BMI), glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), homeostasis model assessment -cell function index (HOMA-), fasting plasma proinsulin (FPPr), proinsulin/fasting plasma insulin ratio (Pr/FPI ratio), adiponectin (ADN), resistin (R), tumor necrosis factor- (TNF-), and high sensitivity C-reactive protein (Hs-CRP) at their baseline values, and after 3, 6, 9, and 12 months of treatment. We observed a similar improvement of HbA1c, FPG, PPG, and Hs-CRP compared to baseline in the 2 groups. Fasting plasma insulin, FPPr, Pr/FPI ratio, R, and TNF- were significantly decreased and ADN was significantly increased with pioglitazone plus vildagliptin, but not with glimepiride plus vildagliptin. HOMA-IR, and HOMA- values obtained with pioglitazone plus vildagliptin were significantly better than the values obtained with glimepiride plus vildagliptin. Pioglitazone plus vildagliptin were found to be more effective in preserving -cell function, and in reducing insulin resistance, and inflammatory state parameters.

Original languageEnglish
Pages (from-to)663-669
Number of pages7
JournalHormone and Metabolic Research
Volume42
Issue number9
DOIs
Publication statusPublished - 2010

Keywords

  • -cell
  • glimepiride
  • inflammatory state
  • insulin resistance
  • pioglitazone
  • vildagliptin

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

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