Comparison of vildagliptin and glimepiride: effects on glycaemic control, fat tolerance and inflammatory markers in people with Type 2 diabetes. Issue 12 (19th June 2014)

• Record Type: Journal Article
• Authors: Derosa, G.; Bonaventura, A.; Bianchi, L.; Romano, D.; Fogari, E.; D'Angelo, A.; Maffioli, P.
• Is Part Of: Diabetic medicine. Volume 31:Issue 12(2014:Dec.)
• Page Start: 1515
• Page End: 1523
• Publication Date: 2014-06-19
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12499
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12499-abs-0001"> <title>Abstract</title> <sec id="dme12499-sec-0001" sec-type="section"> <title>Aims</title> <p>To compare the effects of vildagliptin with those of glimepiride on glycaemic control, fat tolerance and inflammatory markers in people with Type 2 diabetes mellitus receiving metformin treatment.</p> </sec> <sec id="dme12499-sec-0002" sec-type="section"> <title>Methods</title> <p>A total of 167 participants were randomized to vildagliptin 50 mg twice a day or glimepiride 2 mg three times a day, for 6 months. We evaluated the following variables: BMI; glycaemic control; fasting plasma insulin; homeostatic model assessment of insulin resistance index; fasting plasma proinsulin; glucagon; lipid profile; adiponectin; high‐sensitivity C‐reactive protein; interleukin‐6; and tumour necrosis factor‐α. A euglycaemic‐hyperinsulinaemic clamp procedure and an oral fat load test were also performed.</p> </sec> <sec id="dme12499-sec-0003" sec-type="section"> <title>Results</title> <p>Despite a similar decrease in HbA<sub>1c</sub> levels (<italic>P </italic>=<italic> </italic>0.009, and <italic>P </italic>=<italic> </italic>0.008, respectively), body weight increased with glimepiride (<italic>P </italic>=<italic> </italic>0.048 vs baseline) and decreased with vildagliptin (<italic>P </italic>=<italic> </italic>0.041 vs baseline and vs glimepiride). Fasting plasma insulin and homeostatic model assessment of insulin resistance index were significantly lower with vildagliptin compared with glimepiride (<italic>P </italic>=<italic> </italic>0.035 and 0.047). M value, an index of insulin sensitivity, increased with vildagliptin, both compared with baseline and with glimepiride (<italic>P </italic>=<italic> </italic>0.028 and 0.039, respectively). Vildagliptin improved all post‐oral fat load peaks of lipid profile compared with glimepiride. Adiponectin levels were higher (<italic>P </italic>=<italic> </italic>0.035) and high‐sensitivity C‐reactive protein levels were lower (<italic>P </italic>=<italic> </italic>0.038) with vildagliptin vs glimepiride. During the oral fat load test, interleukin‐6, high‐sensitivity C‐reactive protein and tumour necrosis factor‐α peaks were lower and adiponectin peak was higher in the vildagliptin group than in the glimepiride group. There was a higher dropout rate as a result of hypoglycaemia in the glimepiride group than in the vildagliptin group.</p> </sec> <sec id="dme12499-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Vildagliptin was more effective than glimepiride in reducing post‐oral fat load peaks of lipid‐trafficking adipocytokines and inflammatory markers.</p> </sec> </abstract>