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- Title
Effect of linagliptin compared with glimepiride on postprandial glucose metabolism, islet cell function and vascular function parameters in patients with type 2 diabetes mellitus receiving ongoing metformin treatment.
- Authors
Forst, Thomas; Anastassiadis, Ernestos; Diessel, Stephan; Löffler, Andrea; Pfützner, Andreas
- Abstract
Background The goal of this study was to investigate the effects of linagliptin compared with glimepiride on alpha and beta cell function and several vascular biomarkers after a standardized test meal. Methods Thirty-nine patients on metformin alone (age, 64 ± 7 years; duration of type 2 diabetes mellitus, 7.8 ± 4.5years, 27 male, 12 female; HbA1c, 57.2 ± 6.9 mmol/mol; mean ± SD) were randomized to receive linagliptin 5 mg ( n = 19) or glimepiride ( n = 20) for a study duration of 12 weeks. Glucagon-like peptide 1, blood glucose, insulin, intact proinsulin, glucagon, plasminogen activator inhibitor-1 (PAI-1), cyclic guanosinmonophosphat and asymetric dimethylarginin levels were measured in the fasting state and postprandial at 30-min intervals for a duration of 5 h. The areas under the curve (AUC0−300 min) were calculated for group comparisons. Results HbA1c, fasting and postprandial glucose levels improved in both groups. An increase in postprandial insulin (22595 ± 5984 pmol/L*min), postprandial intact proinsulin (1359 ± 658 pmol/L*min), postprandial glucagon (317 ± 1136 pg/mL*min) and postprandial PAI-1 levels (863 ± 467 ng/mL*min) could be observed during treatment with glimepiride, whereas treatment with linagliptin was associated with a decrease in postprandial insulin (−8007 ± 4204 pmol/L*min), intact proinsulin (−1771 ± 426 pmol/L*min), postprandial glucagon (−1597 ± 1831 pg/mL*min) and PAI-1 levels (−410 ± 276 ng/mL*min). Conclusions Despite an improvement in blood glucose control in both groups, linagliptin reduced postprandial insulin, proinsulin, glucagon and PAI-levels. These results indicate an improvement in postprandial alpha and beta cell function, as well as a reduced postprandial vascular risk profile during treatment with linagliptin. Copyright © 2014 John Wiley & Sons, Ltd.
- Publication
Diabetes/Metabolism Research & Reviews, 2014, Vol 30, Issue 7, p582
- ISSN
1520-7552
- Publication type
Article
- DOI
10.1002/dmrr.2525