Initial combination therapy with DPP-IV inhibitors more effectively reduced MAGE than stepwise add-on therapies ( p = 0.006 ) , although no differences in MAGE were found based on HbA1c values .
These findings indicate that DPP-IV inhibitors are promising alternatives for reducing GV in type 2 diabetes patients .
Glycemic variability ( GV ) has been an emerging target for preventing complications related to type 2 diabetes .
For reducing GV , DPP-IV inhibitors have shown effectiveness compared to other oral anti-hyperglycemic drugs ( OADs ) , but systematic evaluation has yet to be existed .
The efficacy and safety of adding either vildagliptin or glimepiride to ongoing metformin therapy in patients with type 2 diabetes mellitus
ABSTRACT Objective : To compare the effects of either vildagliptin or glimepiride on glycemic variability , oxidative stress , and endothelial parameters in patients with type 2 diabetes mellitus ( T2DM ) inadequately controlled with metformin alone . Methods : In this r and omized , open-label , parallel study , 34 patients with T2DM being treated with metformin having an HbA1c of 7.0–10.0 % were allocated into either the vildagliptin or glimepiride group . A mixed-meal tolerance test and 72-hour continuous glucose monitoring were conducted , and urinary 8-iso-prostagl and inF2α ( PGF2α ) and endothelial-dependent flow-mediated dilatation ( FMD ) were evaluated at baseline and after 12 weeks of treatment . Results : Similar significant improvements in HbA1c level were shown in both vildagliptin ( −0.8 % ) and glimepiride ( −0.9 % ) groups after treatment ( Ps<0.001 ) . The mean amplitude of glycemic excursions ( MAGE ) and the mean of daily differences ( MODD ) were significantly decreased by vildagliptin ( P = 0.044 and P = 0.031 , respectively ) but not by glimepiride . Glimepiride was significantly associated with a higher incidence of hypoglycemia than vildagliptin ( P = 0.005 ) . There were no significant differences in urinary 8-iso-PGF2α or FMD between the two groups . Conclusions : Vildagliptin effectively improved glucose level with a significantly greater reduction in glycemic variability and hypoglycemia than glimepiride in patients with T2DM ongoing metformin therapy . The two drugs showed no significant differences in urinary 8-iso-PGF2α and FMD . Trial registration :
Initial combination therapy with DPP-IV inhibitors more effectively reduced MAGE than stepwise add-on therapies ( p = 0.006 ) , although no differences in MAGE were found based on HbA1c values .
These findings indicate that DPP-IV inhibitors are promising alternatives for reducing GV in type 2 diabetes patients .
Glycemic variability ( GV ) has been an emerging target for preventing complications related to type 2 diabetes .
For reducing GV , DPP-IV inhibitors have shown effectiveness compared to other oral anti-hyperglycemic drugs ( OADs ) , but systematic evaluation has yet to be existed .