Unbound MEDLINE

Effects of a combination of sitagliptin plus metformin vs metformin monotherapy on glycemic control, β-cell function and insulin resistance in type 2 diabetic patients.

Abstract

AIMS
To evaluate the impact on glycemic control, insulin resistance, and insulin secretion of sitagliptin+metformin compared to metformin in type 2 diabetic patients.
METHODS
Patients were instructed to take metformin for 8 ± 2 months, then they were randomly assigned to sitaglipin 100 mg or placebo for 12 months. We evaluated at 3, 6, 9, and 12 months: body mass index (BMI), glycemic control, fasting plasma insulin (FPI), HOMA-IR, HOMA-β, fasting plasma proinsulin (FPPr), proinsulin/fasting plasma insulin ratio (Pr/FPI ratio), C-peptide, glucagon, adiponectin (ADN), and high sensitivity-C reactive protein (Hs-CRP). Before, and after 12 months since the addition of sitagliptin, patients underwent a combined euglycemic hyperinsulinemic and hyperglycemic clamp, with subsequent arginine stimulation.
RESULTS
Both treatments similarly decreased body weight, and BMI; on the other hand, they both improved glycemic control, glucagon and HOMA-IR, but sitagliptin+metformin were more effective in reducing these parameters. Sitagliptin+metformin, but not placebo+metformin, decreased FPPr, FPPR/FPI ratio, and increased C-peptide values, even if no differences between the groups were recorded. Sitaglitin+metformin gave also a greater increase of HOMA-β, M value, C-peptide response to arginine and disposition index compared to placebo+metformin group.
CONCLUSIONS
Other than improving glycemic control, sitagliptin+metformin also improved β-cell function better than metformin alone.

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  • Publisher Full Text

    • Authors

    Derosa G, Carbone A, Franzetti I, Querci F, Fogari E, Bianchi L, Bonaventura A, Romano D, Cicero AF, Maffioli P

    Institution

    Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. giuseppe.derosa@unipv.it

    Source

    Diabetes research and clinical practice 98:1 2012 Oct pg 51-60

    MeSH

    Blood Glucose
    C-Peptide
    C-Reactive Protein
    Diabetes Mellitus, Type 2
    Double-Blind Method
    Drug Therapy, Combination
    Exercise
    Fasting
    Female
    Glucagon
    Glucose Clamp Technique
    Hemoglobin A, Glycosylated
    Humans
    Hypoglycemic Agents
    Insulin Resistance
    Insulin-Secreting Cells
    Italy
    Male
    Metformin
    Middle Aged
    Pyrazines
    Treatment Outcome
    Triazoles

    Pub Type(s)

    Journal Article
    Multicenter Study
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    22682949