Comparison of glycaemic control over 1 year with pioglitazone or gliclazide in patients with Type 2 diabetes.
Diabet Med
; 23(3): 246-52, 2006 Mar.
Article
em En
| MEDLINE
| ID: mdl-16492206
ABSTRACT
AIMS:
To compare long-term (1 year) efficacy and safety of pioglitazone and gliclazide in patients with Type 2 diabetes.METHODS:
This was a double-blind, multicentre, comparative, parallel group trial in 283 patients with Type 2 diabetes, who were randomized to receive 1-year treatment with pioglitazone 30-45 mg/day or gliclazide 80-320 mg/day. Drug dose was titrated on the basis of self-monitored blood glucose (SMBG) measurements and HbA1c values. The 1-year changes in HbA1c, fasting blood glucose (FBG), insulin, HOMA-S (HOmeostatic Model Assessment) and SMBG were compared. In a subgroup of patients (n = 10), systemic glucose production and utilization were determined by a combination of isotopic (deuterated glucose) and clamp techniques.RESULTS:
In both groups, there were similar decreases in HbA1c (pioglitazone -0.79%; gliclazide -0.79%) and FBG (pioglitazone -1.0 mmol/l; gliclazide -0.7 mmol/l), whereas the slope of the reduction of fasting blood glucose was different between groups (P = 0.004). Insulin levels as well as insulin resistance assessed using HOMA-S decreased significantly only after pioglitazone treatment (-11.94 pmol/l and -1.03, respectively, both P = 0.002 vs. baseline). A significantly greater reduction in systemic glucose production was observed in the pioglitazone group (-2.48 micromol/kg/min, P = 0.042) than in the gliclazide group (-1.02 micromol/kg/min). A few, mild adverse events occurred in both groups.CONCLUSIONS:
A comparable decrease in HbA1c and FBG was observed with pioglitazone and gliclazide. However, with pioglitazone there was a continuous decrease in FBG over 1 year, whereas gliclazide failed to maintain a similar trend. This favourable effect of pioglitazone was due to its insulin-sensitizing effect and ability to decrease systemic glucose production.
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Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Glicemia
/
Tiazolidinedionas
/
Diabetes Mellitus Tipo 2
/
Gliclazida
/
Hipoglicemiantes
Tipo de estudo:
Clinical_trials
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Diabet Med
Ano de publicação:
2006
Tipo de documento:
Article