Changes in Prandial Glucagon Levels After a 2-Year Treatment With Vildagliptin or Glimepiride in Patients With Type 2 Diabetes Inadequately Controlled With Metformin Monotherapy

被引:79
作者
Ahren, Bo [1 ]
Foley, James E. [2 ]
Ferrannini, Ele [3 ,4 ]
Matthews, David R. [5 ,6 ]
Zinman, Bernard [7 ]
Dejager, Sylvie [8 ]
Fonseca, Vivian A. [9 ]
机构
[1] Lund Univ, Dept Med, Lund, Sweden
[2] Novartis Pharmaceut, E Hanover, NJ USA
[3] Univ Pisa, Dept Internal Med, Pisa, Italy
[4] Univ Pisa, CNR, Inst Clin Physiol, Pisa, Italy
[5] Churchill Hosp, Oxford Ctr Diabet Endocrinol & Metab, Oxford OX3 7LJ, England
[6] Natl Inst Hlth Res, Oxford Biomed Res Ctr, Oxford, England
[7] Univ Toronto, Mt Sinai Hosp, Samuel Lunenfeld Res Inst, Toronto, ON M5G 1X5, Canada
[8] Novartis Pharma SAS, Clin Res, Rueil Malmaison, France
[9] Tulane Univ, Hlth Sci Ctr, Dept Endocrinol, New Orleans, LA 70118 USA
关键词
BETA-CELL FUNCTION; IV INHIBITOR VILDAGLIPTIN; ISLET FUNCTION; GLYCEMIA;
D O I
10.2337/dc09-1867
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - To determine if the dipeptidyl peptidase-4 inhibitor vildagliptin more effectively inhibits glucagon levels than the sulfonylurea glimepiride during a meal. RESEARCH DESIGN AND METHODS - Glucagon responses to a standard meal were measured at baseline and study end point (mean 1.8 years) in a trial evaluating add-on therapy to metformin with 50 mg vildagliptin bid. compared with glimepiride up to 6 mg q.d. in type 2 diabetes (baseline MC 7.3 +/- 0.6%). RESULTS - A1C and prandial glucose area under the curve (AUC)(0-2 h) were reduced similarly in both groups, whereas prandial insulin AUC(0-2 h) increased to a greater extent by glimepiride. Prandial glucagon AUC(0-2 h) (baseline 66.6 +/- 2.3 pmol . h(-1) . l(-1)) decreased by 3.4 +/- 1.6 pmol . h(-1) . l(-1) by vildagliptin (n = 137) and increased by 3.8 +/- 1.7 pmol . h(-1) . l(-1) by glimepiride (n = 121). The between-group difference was 7.3 +/- 2.1 pmol . h(-1) . l(-1) (P < 0.001). CONCLUSIONS - Vildagliptin therapy but not glimepiride improves postprandial a-cell function, which persists for at least 2 years.
引用
收藏
页码:730 / 732
页数:3
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