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 synergistic effects of saxagliptin and metformin on CD34+ endothelial progenitor cells in early type 2 diabetes patients: a randomized clinical trial
Aims Type 2 diabetes is associated with endothelial dysfunction leading to cardiovascular disease . CD34 + endothelial Progenitor Cells ( EPCs ) are responsible for endothelial repair and neo-angiogenesis and can be used as a cardiovascular disease risk biomarker . This study investigated whether the addition of saxagliptin , a DPP-IV inhibitor , to metformin , may reduce cardiovascular disease risk in addition to improving glycemic control in Type 2 diabetes patients . Methods In 12 week , double-blind , r and omized placebo-controlled trial , 42 subjects already taking metformin 1–2 grams/day were r and omized to placebo or saxagliptin 5 mg . Subjects aged 40–70 years with diabetes for < 10 years , with no known cardiovascular disease , BMI 25–39.9 , HbA1C 6–9 % were included . We evaluated EPCs number , function , surface markers and gene expression , in addition to arterial stiffness , blood biochemistries , resting energy expenditure , and body composition parameters . A mixed model regression to examine saxagliptin vs placebo , accounting for within-subject autocorrelation , was done with SAS ( p < 0.05 ) . Results Although there was no significant increase in CD34 + cell number , CD31 + cells percentage increased . Saxagliptin  increased migration ( in response to SDF1α ) with a trend of higher colony formation count . MNCs cytometry showed higher percentage of CXCR4 double positivity for both CD34 and CD31 positive cells , indicating a functional improvement . Gene expression analysis showed an upregulation in CD34 + cells for antioxidant SOD1 ( p < 0.05 ) and a downregulation in CD34− cells for IL-6 ( p < 0.01 ) . For arterial stiffness , both augmentation index and systolic blood pressure measures went down in saxagliptin subjects ( p < 0.05 ) . ConclusionS axagliptin , in combination with metformin , can help improve endothelial dysfunction in early diabetes before macrovascular complications appear . Trial registration Trial is registered under clinical trials.gov ,
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 .