Effects of short-term therapy with different insulin secretagogues on glucose metabolism, lipid parameters and oxidative stress in newly diagnosed Type 2 Diabetes Mellitus.
OBJECTIVE
To compare effects of three different insulin secretagogues on early-phase insulin secretion, metabolism of glucose and lipids, and lipid peroxidation in newly diagnosed Type 2 Diabetes Mellitus (T2DM).


METHODS
Totally 60 newly diagnosed T2DM outpatients were randomized to three groups with 1-month monotherapy of repaglinide (Rg), glimepiride (Gm) or gliclazide MR (Gli), respectively. Some indexes of early-phase insulin secretion, glucose, lipids, and lipid peroxidation were inspected.


RESULTS
Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA(1c)) and fructosamine (FA) were improved in all groups similarly (p>0.05). Rg group was with the highest early-phase insulin secretion index (DeltaI30/DeltaG30) (p=0.026), lower mean amplitude of glycaemic excursion (MAGE) (p<0.05), lowest mean peak value of post-lunch glucose (p=0.043), and lowest postprandial triglyceride (TG) (p=0.039). Postprandial free fatty acid (FFA) was lower after Rg and Gli treatment (p<0.05). Serum 8-iso prostaglandin F(2alpha) (8-iso PGF(2alpha)) was improved in all groups, but the improvement showed statistically significant only in Rg group (p=0.04).


CONCLUSIONS
Rg, Gm and Gli can all decrease blood glucose effectively in newly diagnosed T2DM patients, while Rg performs outstandingly in the aspects of improving early-phase insulin secretion, glucose excursion, postprandial lipids and 8-iso PGF(2alpha).
Li
Yan
Y
Department of Endocrinology and Metabology, Sun Yat-Sen Memorial Hospital, Guangzhou, China. liyan19642002@yahoo.cn
Xu
Lijuan
L
Shen
Jie
J
Ran
Jianmin
J
Zhang
Yang
Y
Wang
Min
M
Yan
Li
L
Cheng
Hua
H
Fu
Zuzhi
Z
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D002219:Carbamates / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D019270:Fructosamine / Q000097:blood; D005907:Gliclazide / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D015227:Lipid Peroxidation / Q000187:drug effects; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D010880:Piperidines / Q000627:therapeutic use; D019518:Postprandial Period / Q000187:drug effects; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D016896:Treatment Outcome
D001786:Blood Glucose; D002219:Carbamates; D019270:Fructosamine; D005907:Gliclazide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008055:Lipids; D010880:Piperidines; D013453:Sulfonylurea Compounds; C072379:repaglinide; C057619:glimepiride