Sitagliptin and pioglitazone provide complementary effects on postprandial glucose and pancreatic islet cell function
(2013) In Diabetes, Obesity and Metabolism 15(12). p.1101-1110- Abstract
- AimsThe effects of sitagliptin and pioglitazone, alone and in combination, on - and -cell function were assessed in patients with type 2 diabetes. MethodsFollowing a 6-week diet/exercise period, 211 patients with HbA1c of 6.5-9.0% and fasting plasma glucose of 7.2-14.4mmol/l were randomized (1:1:1:1) to sitagliptin, pioglitazone, sitagliptin+pioglitazone or placebo. At baseline and after 12weeks, patients were given a mixed meal followed by frequent blood sampling for measurements of glucose, insulin, C-peptide and glucagon. ResultsAfter 12weeks, 5-h glucose total area under the curve (AUC) decreased in all active treatments versus placebo; reduction with sitagliptin+pioglitazone was greater versus either monotherapy. The 5-h insulin total... (More)
- AimsThe effects of sitagliptin and pioglitazone, alone and in combination, on - and -cell function were assessed in patients with type 2 diabetes. MethodsFollowing a 6-week diet/exercise period, 211 patients with HbA1c of 6.5-9.0% and fasting plasma glucose of 7.2-14.4mmol/l were randomized (1:1:1:1) to sitagliptin, pioglitazone, sitagliptin+pioglitazone or placebo. At baseline and after 12weeks, patients were given a mixed meal followed by frequent blood sampling for measurements of glucose, insulin, C-peptide and glucagon. ResultsAfter 12weeks, 5-h glucose total area under the curve (AUC) decreased in all active treatments versus placebo; reduction with sitagliptin+pioglitazone was greater versus either monotherapy. The 5-h insulin total AUC increased with sitagliptin versus all other treatments and increased with sitagliptin+pioglitazone versus pioglitazone. The 3-h glucagon AUC decreased with sitagliptin versus placebo and decreased with sitagliptin+pioglitazone versus pioglitazone or placebo. (s), a measure of dynamic -cell responsiveness to above-basal glucose concentrations, increased with either monotherapy versus placebo and increased with sitagliptin+pioglitazone versus either monotherapy. The insulin sensitivity index (ISI), a composite index of insulin sensitivity, improved with pioglitazone and sitagliptin+pioglitazone versus placebo. The disposition index, a measure of the relationship between -cell function and insulin sensitivity, improved with all active treatments versus placebo. Conclusions<p id="dom12145-para-0004">Sitagliptin and pioglitazone enhanced -cell function (increasing postmeal phi(s)), and sitagliptin improved -cell function (decreasing postmeal glucagon) after 12weeks in patients with type 2 diabetes. Through these complementary mechanisms of action, the combination of sitagliptin and pioglitazone reduced postmeal glucose more than either treatment alone. (Less)
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https://lup.lub.lu.se/record/4204316
- author
- Alba, M. ; Ahrén, Bo LU ; Inzucchi, S. E. ; Guan, Y. ; Mallick, M. ; Xu, L. ; O'Neill, E. A. ; Williams-Herman, D. E. ; Kaufman, K. D. and Goldstein, B. J.
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- dipeptidyl peptidase-4 inhibitors, DPP-4, incretins, MK-0431, PPAR, agonist
- in
- Diabetes, Obesity and Metabolism
- volume
- 15
- issue
- 12
- pages
- 1101 - 1110
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000326500900006
- scopus:84887140574
- ISSN
- 1462-8902
- DOI
- 10.1111/dom.12145
- language
- English
- LU publication?
- yes
- id
- bd090483-05c8-4c98-8004-7577df8020b9 (old id 4204316)
- date added to LUP
- 2016-04-01 10:59:20
- date last changed
- 2024-01-22 03:54:59
@article{bd090483-05c8-4c98-8004-7577df8020b9,
abstract = {{AimsThe effects of sitagliptin and pioglitazone, alone and in combination, on - and -cell function were assessed in patients with type 2 diabetes. MethodsFollowing a 6-week diet/exercise period, 211 patients with HbA1c of 6.5-9.0% and fasting plasma glucose of 7.2-14.4mmol/l were randomized (1:1:1:1) to sitagliptin, pioglitazone, sitagliptin+pioglitazone or placebo. At baseline and after 12weeks, patients were given a mixed meal followed by frequent blood sampling for measurements of glucose, insulin, C-peptide and glucagon. ResultsAfter 12weeks, 5-h glucose total area under the curve (AUC) decreased in all active treatments versus placebo; reduction with sitagliptin+pioglitazone was greater versus either monotherapy. The 5-h insulin total AUC increased with sitagliptin versus all other treatments and increased with sitagliptin+pioglitazone versus pioglitazone. The 3-h glucagon AUC decreased with sitagliptin versus placebo and decreased with sitagliptin+pioglitazone versus pioglitazone or placebo. (s), a measure of dynamic -cell responsiveness to above-basal glucose concentrations, increased with either monotherapy versus placebo and increased with sitagliptin+pioglitazone versus either monotherapy. The insulin sensitivity index (ISI), a composite index of insulin sensitivity, improved with pioglitazone and sitagliptin+pioglitazone versus placebo. The disposition index, a measure of the relationship between -cell function and insulin sensitivity, improved with all active treatments versus placebo. Conclusions<p id="dom12145-para-0004">Sitagliptin and pioglitazone enhanced -cell function (increasing postmeal phi(s)), and sitagliptin improved -cell function (decreasing postmeal glucagon) after 12weeks in patients with type 2 diabetes. Through these complementary mechanisms of action, the combination of sitagliptin and pioglitazone reduced postmeal glucose more than either treatment alone.}},
author = {{Alba, M. and Ahrén, Bo and Inzucchi, S. E. and Guan, Y. and Mallick, M. and Xu, L. and O'Neill, E. A. and Williams-Herman, D. E. and Kaufman, K. D. and Goldstein, B. J.}},
issn = {{1462-8902}},
keywords = {{dipeptidyl peptidase-4 inhibitors; DPP-4; incretins; MK-0431; PPAR; agonist}},
language = {{eng}},
number = {{12}},
pages = {{1101--1110}},
publisher = {{Wiley-Blackwell}},
series = {{Diabetes, Obesity and Metabolism}},
title = {{Sitagliptin and pioglitazone provide complementary effects on postprandial glucose and pancreatic islet cell function}},
url = {{http://dx.doi.org/10.1111/dom.12145}},
doi = {{10.1111/dom.12145}},
volume = {{15}},
year = {{2013}},
}