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
- Authors
- Kim, Nam Hoon; Kim, Dong-Lim; Kim, Kyeong Jin; Kim, Nan Hee; Choi, Kyung Mook; Baik, Sei Hyun; Kim, Sin Gon
- Issue Date
- Jun-2017
- Publisher
- KOREAN ENDOCRINE SOC
- Keywords
- Glycemic variability; Dipeptidyl-peptidase IV inhibitors; Thiazolidinediones; Diabetes mellitus; type 2
- Citation
- ENDOCRINOLOGY AND METABOLISM, v.32, no.2, pp.241 - 247
- Indexed
- SCOPUS
KCI
- Journal Title
- ENDOCRINOLOGY AND METABOLISM
- Volume
- 32
- Number
- 2
- Start Page
- 241
- End Page
- 247
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/83390
- DOI
- 10.3803/EnM.2017.32.2.241
- ISSN
- 2093-596X
- 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 F2 alpha, 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 F2a 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.
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