Adding glimepiride to current insulin therapy increases high-molecular weight adiponectin levels to improve glycemic control in poorly controlled type 2 diabetes

Abstract

BackgroundTo observe the efficacy and safety of adding glimepiride to established insulin therapy in poorly controlled type 2 diabetes (T2D) and to assess the relationship of changes in the serum high-molecular weight (HMW) adiponectin levels and glycemic control after glimepiride treatment.MethodsFifty-six subjects with poorly controlled insulin-treated T2D were randomly assigned to either the glimepiride-added group (the group A, n = 29) or the insulin-increasing group (the group B, n = 27) while continuing current insulin-based therapy. Glycosylated hemoglobin (HbA1c) value, daily insulin dose, body weight, waist circumference, plasma lipid concentration, serum HMW adiponectin level and the number of hypoglycemic events were evaluated before and after treatment.ResultsAt the end of study, insulin doses were significantly reduced, and the mean HbA1c, fasting blood glucose (FBG) and 2-hour postprandial blood glucose (P2BG) were improved greater in the group A compared with the group B. The serum HMW adiponectin levels were significantly increased in the group A compared with the group B. Most importantly, we found that changes in HbA1c were inversely correlated with changes in serum HMW adiponectin in the group A (r = −0.452, p = 0.02).ConclusionsAdding glimepiride to current insulin treatment led to better improvement in glycemic control with a significant smaller daily insulin dose, and the increases in the serum HMW adiponectin levels may directly contribute to improvement glycemic control.

Association between the level of circulating adiponectin and prediabetes: A meta‐analysis

“…However, inconsistent results regarding this have been reported in another two studies. Using the adiponectin gene summary statistics genetic risk scores, Mente et al . found no evidence of an association between adiponectin‐lowering alleles and insulin sensitivity, which do not support a causal role for reduced circulating adiponectin levels in insulin resistance and type 2 diabetes.…”

“…However, inconsistent results regarding this have been reported in another two studies 8,[47][48][49] . Using the adiponectin gene summary statistics genetic risk scores, Mente et al 42,47 found no evidence of an association between adiponectin-lowering alleles and insulin sensitivity, which do not support a causal role for reduced circulating adiponectin levels in insulin resistance and type 2 diabetes. In addition, Hammana et al 7 found no alterations in adiponectin levels despite insulin resistance, glucose intolerance and subclinical chronic inflammation in cystic fibrosis patients.…”

“…The same results were shown in other studies [37][38][39] . In addition, several case-control studies by Pauer et al 40 reported that prediabetes are associated with lower circulating adiponectin concentrations in patients with insulin resistance and type 2 diabetes [41][42][43] , as well as in patients with prediabetic conditions 25,[44][45][46] .…”

Metabolic effects of antidiabetic drugs on adipocytes and adipokine expression

“…Moreover, C.-J. Li, Zhang, Yu, & Zhang (2014) suggested that adding sulfonylureas to insulin therapy in poorly controlled diabetic subjects…”

The differential influence of glimepiride and glibenclamide on insulin resistance and adiponectin levels in patients with type 2 diabetes

“…Due to the fact that glimepiride compared to all other SUs might act beneficially on other metabolic changes in T2DM, several studies suggesting that this might be due to adiponectin, i.e. high-molecular adiponectin following glimepiride treatment [10,11] Thus, we aimed to assess whether there are differences in plasma adiponectin concentration and its repercussion to IR and MS components in two types of SU regimes in overweight and obese T2DM patients as previously suggested on molecular level.…”