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)
Please use this url to cite or link to this publication:
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}}, }