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 relative importance of vascular structure and function in predicting cardiovascular events.
OBJECTIVES We sought to assess the prognostic utility of brachial artery reactivity ( BAR ) in patients at risk of cardiovascular events . BACKGROUND Impaired flow-mediated vasodilation measured by BAR is a marker of endothelial dysfunction . Brachial artery reactivity is influenced by risk factors and is responsive to various pharmacological and other treatments . However , its prognostic importance is uncertain , especially relative to other predictors of outcome . METHODS A total of 444 patients were prospect ively enrolled to undergo BAR and follow-up .  These patients were at risk of cardiovascular events , based on the presence of risk factors or known or suspected cardiovascular disease . We took a full clinical history , performed BAR , and obtained carotid intima-media thickness ( IMT ) and left ventricular mass and ejection fraction . Patients were followed up for cardiovascular events and all-cause mortality . Multivariate Cox regression analysis was performed to assess the independent association of investigation variables on outcomes . RESULTS The patients exhibited abnormal BAR ( 5.2 + /- 6.1 % [ mean + /- SD ] ) but showed normal nitrate-mediated dilation ( 9.9 + /- 7.2 % ) and normal mean IMT ( 0.67 + /- 0.12 mm [ average ] ) . Forty-nine deaths occurred over the median follow-up period of 24 months ( interquartile range 10 to 34 ) . Patients in the lowest tertile group of BAR ( < 2 % ) had significantly more events than those in the combined group of highest and mid-tertiles ( p = 0.029 , log-rank test ) . However , mean IMT ( rather than flow-mediated dilation ) was the vascular factor independently associated with mortality , even in the subgroup ( n = 271 ) with no coronary artery disease and low risk . CONCLUSIONS Brachial artery reactivity is lower in patients with events , but is not an independent predictor of cardiovascular outcomes in this cohort of patients
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 .