Effects of Vildagliptin or Pioglitazone on Glycemic Variability and Oxidative Stress in Patients with Type 2 Diabetes Inadequately Controlled with Metformin Monotherapy: A 16-Week, Randomised, Open Label, Pilot Study.
10.3803/EnM.2017.32.2.241
- Author:
Nam Hoon KIM
1
;
Dong Lim KIM
;
Kyeong Jin KIM
;
Nan Hee KIM
;
Kyung Mook CHOI
;
Sei Hyun BAIK
;
Sin Gon KIM
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. k50367@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Glycemic variability;
Dipeptidyl-peptidase IV inhibitors;
Thiazolidinediones;
Diabetes mellitus, type 2
- MeSH:
Blood Glucose;
C-Reactive Protein;
Diabetes Complications;
Diabetes Mellitus, Type 2;
Dipeptidyl Peptidase 4;
Dipeptidyl-Peptidase IV Inhibitors;
Glucose;
Hemoglobin A, Glycosylated;
Humans;
Inflammation;
Lipoproteins;
Metformin*;
Oxidative Stress*;
Pilot Projects*;
Thiazolidinediones
- From:Endocrinology and Metabolism
2017;32(2):241-247
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Glycemic variability is associated with the development of diabetic complications through the activation of oxidative stress. This study aimed to evaluate the effects of a dipeptidyl peptidase 4 inhibitor, vildagliptin, or a thiazolidinedione, pioglitazone, on glycemic variability and oxidative stress in patients with type 2 diabetes. METHODS: In this open label, randomised, active-controlled, pilot trial, individuals who were inadequately controlled with metformin monotherapy were assigned to either vildagliptin (50 mg twice daily, n=17) or pioglitazone (15 mg once daily, n=14) treatment groups for 16 weeks. Glycemic variability was assessed by calculating the mean amplitude of glycemic excursions (MAGE), which was obtained from continuous glucose monitoring. Urinary 8-iso prostaglandin F₂α, serum oxidised low density lipoprotein, and high-sensitivity C-reactive protein were used as markers of oxidative stress or inflammation. RESULTS: Both vildagliptin and pioglitazone significantly reduced glycated hemoglobin and mean plasma glucose levels during the 16-week treatment. Vildagliptin also significantly reduced the MAGE (from 93.8±38.0 to 70.8±19.2 mg/dL, P=0.046), and mean standard deviation of 24 hours glucose (from 38±17.3 to 27.7±6.9, P=0.026); however, pioglitazone did not, although the magnitude of decline was similar in both groups. Markers of oxidative stress or inflammation including urinary 8-iso prostaglandin F₂α did not change after treatment in both groups. CONCLUSION: In this 16-week treatment trial, vildagliptin, but not pioglitazone, reduced glycemic variability in individuals with type 2 diabetes who was inadequately controlled with metformin monotherapy, although a reduction of oxidative stress markers was not observed.
