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Horm Metab Res 2010; 42(9): 663-669
DOI: 10.1055/s-0030-1255036
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Effects of One Year Treatment of Vildagliptin Added to Pioglitazone or Glimepiride in Poorly Controlled Type 2 Diabetic Patients

G. Derosa1 , P. Maffioli1 , I. Ferrari1 , R. Mereu1 , P. D. Ragonesi2 , F. Querci3 , I. G. Franzetti4 , G. Gadaleta5 , L. Ciccarelli6 , M. N. Piccinni7 , A. D’Angelo1 , S. A. T. Salvadeo1
  • 1Department of Internal Medicine and Therapeutics, University of Pavia,Pavia, Italy
  • 2Diabetes Care Unit, S. Carlo Hospital, Milano, Italy
  • 3Ospedale Pesenti Fenaroli, Alzano Lombardo, Bergamo, Italy
  • 4Metabolic Unit, Regional Hospital, Varese, Italy
  • 5Division of Medicine, Civic Hospital, Cittiglio, Varese, Italy
  • 6RSA Don Leone Porta, Milano, Italy
  • 7Fondazione Ospedale della Carità, Casalbuttano, Cremona, Italy
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Publication History

received 08.01.2010

accepted 03.05.2010

Publication Date:
17 June 2010 (online)

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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 30 mg once a day plus vildagliptin 50 mg twice a day or glimepiride 2 mg 3 times a day plus vildagliptin 50 mg 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 β-cell function index (HOMA-β), fasting plasma proinsulin (FPPr), proinsulin/fasting plasma insulin ratio (Pr/FPI ratio), adiponectin (ADN), resistin (R), tumor necrosis factor-α (TNF-α), 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-α were significantly decreased and ADN was significantly increased with pioglitazone plus vildagliptin, but not with glimepiride plus vildagliptin. HOMA-IR, and HOMA-β 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 β-cell function, and in reducing insulin resistance, and inflammatory state parameters.

Key words

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

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Correspondence

G. DerosaMD, PhD 

Department of Internal Medicine

and Therapeutics

University of Pavia, Fondazione

IRCCS Policlinico S. Matteo

P. le C. Golgi 2

27100 Pavia

Italy

Phone: +39/0382/52 6217

Fax: +39/0382/52 6259

Email: giuseppe.derosa@unipv.it