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Exp Clin Endocrinol Diabetes 2014; 122(05): 295-302
DOI: 10.1055/s-0034-1370989
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Comparison of Effects of Gliclazide, Metformin and Pioglitazone Monotherapies on Glycemic Control and Cardiovascular Risk Factors in Patients with Newly Diagnosed Uncontrolled Type 2 Diabetes Mellitus

C. Erem   *
1   Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
,
H. M. Ozbas
1   Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
,
İ. Nuhoglu   *
1   Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
,
O. Deger   *
2   Department of Medical Biochemistry, The Trabzon Endocrinological Studies Group, Trabzon, Turkey
,
N. Civan
1   Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
,
H. O. Ersoz
1   Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
› Author Affiliations
Further Information

Publication History

received 04 October 2013
first decision 11 February 2014

accepted 24 February 2014

Publication Date:
07 April 2014 (online)

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Abstract

Objective: The objective of this study was to evaluate and compare the effects of gliclazide-modified release (gliclazide-MR), metformine (MET) and pioglitazone (PIO) monotherapies on glycemic control and conventional/non-conventional cardiovascular risk factors in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

Material and Methods: A single center, randomized, 52-wk comparator-controlled clinical study was carried out in patients with newly diagnosed uncontrolled T2DM. A total of 57 patients were randomized into gliclazide-MR, metformin and pioglitazone groups. Drugs were administered for 12 months. Anthropometric measurements, fasting plasma glucose (FPG), postprandial plasma glucose (PPG), HbA1c, insulin, HOMA-IR, lipid parameters, the markers of coagulation/fibrinolysis, inflammation and endothelial dysfunction were measured at baseline and at months 3, 6, and 12.

Results: In the gliclazide-MR group, HC, FPG, HbA1c, insulin, HOMA-IR, TC, trigylcerides, Lp (a), E-selectin and Hcy were significantly decreased after treatment compared to baseline. In the MET group, BMI, WC, FPG, PPG, HbA1c, ICAM-1 and Hcy significantly decreased after treatment compared to baseline. In PIO group, WC, HC, FPG, PPG, HbA1c, C-peptid, HOMA-IR, trigylcerides, vWF, IL-6, ICAM-1, E-selectin and Hcy significantly decreased after treatment compared to baseline, whereas, HDL-C increased. At the end of the month 12, the decreases in insulin and HOMA-IR score were more pronounced with PIO compared to gliclazide.

Conclusions: Gliclazide-MR, MET and PIO monotherapies, were equally effective in proving glycemic control in patients with newly diagnosed, oral antidiabetic (OAD)-naive T2DM. But, improvements in conventional/non-conventional cardiovascular risk factors were more pronounced in patients on PIO therapy compared to gliclazide and MET therapies. Also, all of the 3 drugs represent effective and safe first-line pharmacological treatment options in these patients.

Key words

gliclazide-MR - metformin - pioglitazone - type 2 diabetes - cardiovascular risk factors - glycemic control

* The Trabzon Endocrinological Studies Group, Trabzon, Turkey


 

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