Kim Gyuri, Oh Sewon, Jin Sang-Man, Hur Kyu Yeon, Kim Jae Hyeon, Lee Moon-Kyu
a Division of Endocrinology and Metabolism, Department of Medicine , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Republic of Korea.
Expert Opin Pharmacother. 2017 Aug;18(12):1179-1186. doi: 10.1080/14656566.2017.1353080. Epub 2017 Jul 17.
To compare the effects of either vildagliptin or glimepiride on glycemic variability, oxidative stress, and endothelial parameters in patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin alone.
In this randomized, open-label, parallel study, 34 patients with T2DM being treated with metformin having an HbA1c of 7.0-10.0% were allocated into either the vildagliptin or glimepiride group. A mixed-meal tolerance test and 72-hour continuous glucose monitoring were conducted, and urinary 8-iso-prostaglandinF (PGF) and endothelial-dependent flow-mediated dilatation (FMD) were evaluated at baseline and after 12 weeks of treatment.
Similar significant improvements in HbA1c level were shown in both vildagliptin (-0.8%) and glimepiride (-0.9%) groups after treatment (Ps<0.001). The mean amplitude of glycemic excursions (MAGE) and the mean of daily differences (MODD) were significantly decreased by vildagliptin (P = 0.044 and P = 0.031, respectively) but not by glimepiride. Glimepiride was significantly associated with a higher incidence of hypoglycemia than vildagliptin (P = 0.005). There were no significant differences in urinary 8-iso-PGF or FMD between the two groups.
Vildagliptin effectively improved glucose level with a significantly greater reduction in glycemic variability and hypoglycemia than glimepiride in patients with T2DM ongoing metformin therapy. The two drugs showed no significant differences in urinary 8-iso-PGF and FMD.
NCT01404676.
比较维格列汀或格列美脲对仅用二甲双胍治疗血糖控制不佳的2型糖尿病（T2DM）患者血糖变异性、氧化应激和内皮参数的影响。
在这项随机、开放标签、平行研究中，将34例接受二甲双胍治疗且糖化血红蛋白（HbA1c）为7.0 - 10.0%的T2DM患者分为维格列汀组或格列美脲组。进行混合餐耐量试验和72小时连续血糖监测，并在基线和治疗12周后评估尿8-异前列腺素F（PGF）和内皮依赖性血流介导的血管舒张功能（FMD）。
治疗后维格列汀组（-0.8%）和格列美脲组（-0.9%）的HbA1c水平均有相似的显著改善（P<0.001）。维格列汀显著降低了血糖波动幅度（MAGE）和每日血糖平均绝对差（MODD）（分别为P = 0.044和P = 0.031），而格列美脲未降低。格列美脲导致低血糖的发生率显著高于维格列汀（P = 0.005）。两组间尿8-异PGF或FMD无显著差异。
在接受二甲双胍治疗的T2DM患者中，维格列汀能有效改善血糖水平，与格列美脲相比，能更显著地降低血糖变异性和低血糖发生率。两种药物在尿8-异PGF和FMD方面无显著差异。
NCT01404676。
