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Metformin plus low-dose glimeperide significantly improves Homeostasis Model Assessment for insulin resistance (HOMA(IR)) and beta-cell function (HOMA(beta-cell)) without hyperinsulinemia in patients with type 2 diabetes mellitus.
Am J Ther. 2007 Mar-Apr; 14(2):194-202.AJ

Abstract

OBJECTIVE

Type 2 diabetes mellitus is characterized by insulin resistance and defects in insulin secretion from pancreatic beta-cells, which have been studied by using euglycemic/hyperinsulinemic clamps. However, it is difficult to study insulin resistance and beta-cell failure by these techniques in humans. Therefore, the aim of this study was to evaluate the effect of three different antidiabetic therapeutic regimens on insulin resistance and beta-cell activity by using a mathematical model, Homeostasis Model Assessment for insulin resistance (HOMA(IR)) and beta-cell function (HOMA(beta-cell)).

RESEARCH DESIGN AND METHODS

Seventy type 2 diabetic patients were randomly assigned to one of three therapeutic regimens: (A) metformin + American Diabetic Association (ADA)-recommended diet + physical activity; (B) metformin + low-dose glimepiride + ADA diet + physical activity; or (C) ADA diet + physical activity (no drugs). Blood samples were obtained before and after the treatment to determine serum levels of fasting and post-prandial blood glucose, fasting insulin, and glycosylated hemoglobin (HbA1c), and HOMA(IR) and HOMA(beta-cell) were calculated.

RESULTS

Fasting and post-prandial levels of glucose, HbA1c, and fasting insulin and calculated HOMA(IR) and HOMA(beta-cell) values before treatment were significantly higher than the respective values after treatment for all groups of patients (P < 0.01). Significant differences were also found when comparing the treatment-induced reduction in fasting blood glucose (51.8%; P < 0.01), post-prandial blood glucose (55.0%; P < 0.05), and HOMA(IR) (65.3%; P < 0.01) in patients of Group B with that in patients receiving other therapeutic options (Groups A and C).

CONCLUSIONS

Metformin plus low-dose glimepiride (plus ADA diet and physical activity) is a more effective treatment for type 2 diabetes than either metformin plus ADA diet and physical activity or ADA diet and physical activity alone. Determination of HOMA(IR) and HOMA(beta-cell) values is an inexpensive, reliable, less invasive, and less labor-intensive method than other tests to estimate insulin resistance and beta-cell function in patients with type 2 diabetes mellitus.

Authors+Show Affiliations

Endocrine and Metabolic Diseases Research Center Dr. Félix Gómez, University of Zulia School of Medicine, Maracaibo, Venezuela. vbermudez@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17414590

Citation

Bermúdez-Pirela, Valmore J., et al. "Metformin Plus Low-dose Glimeperide Significantly Improves Homeostasis Model Assessment for Insulin Resistance (HOMA(IR)) and Beta-cell Function (HOMA(beta-cell)) Without Hyperinsulinemia in Patients With Type 2 Diabetes Mellitus." American Journal of Therapeutics, vol. 14, no. 2, 2007, pp. 194-202.
Bermúdez-Pirela VJ, Cano C, Medina MT, et al. Metformin plus low-dose glimeperide significantly improves Homeostasis Model Assessment for insulin resistance (HOMA(IR)) and beta-cell function (HOMA(beta-cell)) without hyperinsulinemia in patients with type 2 diabetes mellitus. Am J Ther. 2007;14(2):194-202.
Bermúdez-Pirela, V. J., Cano, C., Medina, M. T., Souki, A., Lemus, M. A., Leal, E. M., Seyfi, H. A., Cano, R., Ciscek, A., Bermúdez-Arias, F., Contreras, F., Israili, Z. H., Hernández-Hernández, R., & Valasco, M. (2007). Metformin plus low-dose glimeperide significantly improves Homeostasis Model Assessment for insulin resistance (HOMA(IR)) and beta-cell function (HOMA(beta-cell)) without hyperinsulinemia in patients with type 2 diabetes mellitus. American Journal of Therapeutics, 14(2), 194-202.
Bermúdez-Pirela VJ, et al. Metformin Plus Low-dose Glimeperide Significantly Improves Homeostasis Model Assessment for Insulin Resistance (HOMA(IR)) and Beta-cell Function (HOMA(beta-cell)) Without Hyperinsulinemia in Patients With Type 2 Diabetes Mellitus. Am J Ther. 2007 Mar-Apr;14(2):194-202. PubMed PMID: 17414590.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metformin plus low-dose glimeperide significantly improves Homeostasis Model Assessment for insulin resistance (HOMA(IR)) and beta-cell function (HOMA(beta-cell)) without hyperinsulinemia in patients with type 2 diabetes mellitus. AU - Bermúdez-Pirela,Valmore J, AU - Cano,Clímaco, AU - Medina,Mayerlim T, AU - Souki,Aida, AU - Lemus,Miguel A, AU - Leal,Elliuz M, AU - Seyfi,Hamid A, AU - Cano,Raquel, AU - Ciscek,Ana, AU - Bermúdez-Arias,Fernando, AU - Contreras,Freddy, AU - Israili,Zafar H, AU - Hernández-Hernández,Rafael, AU - Valasco,Manuel, PY - 2007/4/7/pubmed PY - 2007/5/26/medline PY - 2007/4/7/entrez SP - 194 EP - 202 JF - American journal of therapeutics JO - Am J Ther VL - 14 IS - 2 N2 - OBJECTIVE: Type 2 diabetes mellitus is characterized by insulin resistance and defects in insulin secretion from pancreatic beta-cells, which have been studied by using euglycemic/hyperinsulinemic clamps. However, it is difficult to study insulin resistance and beta-cell failure by these techniques in humans. Therefore, the aim of this study was to evaluate the effect of three different antidiabetic therapeutic regimens on insulin resistance and beta-cell activity by using a mathematical model, Homeostasis Model Assessment for insulin resistance (HOMA(IR)) and beta-cell function (HOMA(beta-cell)). RESEARCH DESIGN AND METHODS: Seventy type 2 diabetic patients were randomly assigned to one of three therapeutic regimens: (A) metformin + American Diabetic Association (ADA)-recommended diet + physical activity; (B) metformin + low-dose glimepiride + ADA diet + physical activity; or (C) ADA diet + physical activity (no drugs). Blood samples were obtained before and after the treatment to determine serum levels of fasting and post-prandial blood glucose, fasting insulin, and glycosylated hemoglobin (HbA1c), and HOMA(IR) and HOMA(beta-cell) were calculated. RESULTS: Fasting and post-prandial levels of glucose, HbA1c, and fasting insulin and calculated HOMA(IR) and HOMA(beta-cell) values before treatment were significantly higher than the respective values after treatment for all groups of patients (P < 0.01). Significant differences were also found when comparing the treatment-induced reduction in fasting blood glucose (51.8%; P < 0.01), post-prandial blood glucose (55.0%; P < 0.05), and HOMA(IR) (65.3%; P < 0.01) in patients of Group B with that in patients receiving other therapeutic options (Groups A and C). CONCLUSIONS: Metformin plus low-dose glimepiride (plus ADA diet and physical activity) is a more effective treatment for type 2 diabetes than either metformin plus ADA diet and physical activity or ADA diet and physical activity alone. Determination of HOMA(IR) and HOMA(beta-cell) values is an inexpensive, reliable, less invasive, and less labor-intensive method than other tests to estimate insulin resistance and beta-cell function in patients with type 2 diabetes mellitus. SN - 1075-2765 UR - https://www.unboundmedicine.com/medline/citation/17414590/Metformin_plus_low_dose_glimeperide_significantly_improves_Homeostasis_Model_Assessment_for_insulin_resistance__HOMA_IR___and_beta_cell_function__HOMA_beta_cell___without_hyperinsulinemia_in_patients_with_type_2_diabetes_mellitus_ DB - PRIME DP - Unbound Medicine ER -