Study comparing the effect of pioglitazone in combination with either metformin or sulphonylureas on lipid profile and glycaemic control in patients with type 2 diabetes (ECLA)

Karamanos, B.; Thanopoulou, Anastasia; Drossinos, Vangelis; Charalampidou, E; Sourmeli, Sotiria; Archimandritis, Athanasios

doi:10.1185/03007995.2010.542081

Cited by 14 publications

(12 citation statements)

References 48 publications

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“…Our study was consistent with others [25]–[28] and showed that acarbose and metformin treatment causes a slight decline of plasma TC and non-HDL-C in the three BMI groups. Acarbose decreased TG more intensively as compared with metformin in overweight and obesity groups.…”

Section: Discussionsupporting

confidence: 93%

MARCH2: Comparative Assessment of Therapeutic Effects of Acarbose and Metformin in Newly Diagnosed Type 2 Diabetes Patients

et al. 2014

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BackgroundThe data of MARCH (Metformin and AcaRbose in Chinese as the initial Hypoglycaemic treatment) trial demonstrated that acarbose and metformin have similar efficacy as initial therapy for hemoglobin A1c (HbA1c) reduction in Chinese patients with newly diagnosed type 2 diabetes. We investigated whether the therapeutic efficacy was diversified under different body mass index (BMI) status.MethodsAll 784 subjects were divided into normal-weight group (BMI<24 kg/m2), overweight group (BMI 24–28 kg/m2) and obese group (BMI≥28 kg/m2). Patients were assigned to 48 weeks of therapy with acarbose or metformin, respectively. The clinical trial registry number was ChiCTR-TRC-08000231.ResultsThe reduction of HbA1c levels and the proportion of patients with HbA1c of 6.5% or less were similar in the three groups after acarbose and metformin treatment. In overweight group, fasting blood glucose (FBG) after metformin treatment showed greater decline compared to acarbose group at 48 weeks [−1.73 (−1.99 to −1.46) vs. −1.37 (−1.61 to −1.12), P<0.05), however the decrease of 2 h post-challenge blood glucose (PBG) after acarbose treatment at 48 weeks was bigger compared to metformin group [−3.34 (−3.83 to−2.84) vs. −2.35 (−2.85 to −1.85), P<0.01 ]. Both acarbose and metformin treatment resulted in a significant decrease in waist circumference, hip circumference, weight and BMI in the three groups (all P<0.05).ConclusionAcarbose and metformin decreased HbA1c levels similarly regardless of BMI status of Chinese type 2 diabetic patients. Acarbose and metformin resulted in a significant and modest improvement of anthropometric parametres in different BMI status. Thus, acarbose treatment may contribute a similar effect on plasma glucose control compared to metformin, even in obesity patients.Trial RegistrationChiCTR.org ChiCTR-TRC-08000231

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Section: Discussionsupporting

confidence: 93%

MARCH2: Comparative Assessment of Therapeutic Effects of Acarbose and Metformin in Newly Diagnosed Type 2 Diabetes Patients

et al. 2014

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“…Previous reports revealed that acarbose and metformin both had some beneficial effects on metabolic syndrome. Our finding was consistent with others [29][30][31][32] and revealed that acarbose and metformin could decrease plasma TC and non-HDL-C slightly in the three groups. The proportion of patients with optimal LDL-C levels with metformin treatment was higher than acarbose in better β-cell function group.…”

Section: Discussionsupporting

confidence: 93%

Comparison of therapeutic effects of acarbose and metformin under different β-cell function status in Chinese patients with type 2 diabetes

Liu

et al. 2019

Endocr J

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MARCH study suggested that acarbose had similar therapeutic effect on glycated hemoglobin reduction compared to metformin in newly diagnosed type 2 diabetes patients as initial therapy in China. We aimed to investigate whether the efficacy of acarbose was still similar to metformin under different β-cell function status. According to the homeostasis model assessment (HOMA)-β level, 670 patients were divided into better β-cell function group, medium β-cell function group and poor β-cell function group. Patients received acarbose 300 mg/d or metformin 1,500 mg/d for 48 weeks. We found both acarbose and metformin could decrease glycated hemoglobin to similar levels after 48 weeks treatment in all groups. In medium β-cell function group, the decrease of fasting blood glucose after metformin treatment was more significant compared to acarbose (p = 0.040); however, the decrease of post-challenge blood glucose after acarbose treatment was more significant compared to metformin (p = 0.020). Moreover, in poor β-cell function group, the decrease of body weight and body mass index after acarbose treatment were significant compared to metformin (p = 0.004 and p = 0.031, respectively). Therefore, acarbose contributed a similar therapeutic effect to plasma glucose control compared to metformin treatment, even under different β-cell function status.DIABETES MELLITUS (DM), a chronic degenerative metabolic disease, is characterized by hyperglycemia and disorders of carbohydrates metabolism, lipids metabolism, and proteins metabolism caused by insulin resistance (IR) and islet β-cell dysfunction [1]. More than 90% of all DM are type 2 diabetes mellitus (T2DM), which is the most common DM [1]. T2DM caused by the complex interaction among gene, environment and other risk factors. T2DM is accelerated by reduced first-phase insulin release, disordered pulsatility of basal insulin secretion, and increased glucagon secretion [2]. Recent * These authors contributed equally to this work. studies have also emphasised the role of early life factors such as maternal undernutrition, maternal obesity, and gestational diabetes linked to increased risk of diabetes in offspring [3]. Complications associated with T2DM are cardiovascular diseases, diabetic neuropathy, nephropathy, and retinopathy [1].Approximately 7.5% Chinese adults in northwest China interviewed had newly diagnosed T2DM [4]. In Tianjin, China, the percentage for T2DM among schoolaged children was small, however, T2DM related risk factors such as overweight and obesity were very common [5,6]. In a cross-sectional survey in Shanghai adults T2DM was found in 10.1% of subjects with higher incidence among patients with hyperlipidemia. This survey also revealed that there were more males (11.4%) than females (9.2%) [6], more elderly (≥65 years 22.5%) than younger (<55 years, <10%) individuals, and more urban residents (12.8%) than rural residents (5.2%) among T2DM patients [7].Joshi et al. and Wang et al. have reported that metformin/acarbose combination has complimentary mechanisms on...

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“…Metformin exhibited antidiabetic activity in terms of reducing glucose as well as triglyceride in the rats exposed to both T2DM and stress paradigm. Metformin decreases T2DM-induced increase in the level of glucose and triglyceride in the plasma of both animals and patients [62, 63]. However, this is the first report of effect of metformin on the rats exposed to both T2DM and stress paradigm.…”

Section: Discussionmentioning

confidence: 99%

Diazepam Potentiates the Antidiabetic, Antistress and Anxiolytic Activities of Metformin in Type-2 Diabetes Mellitus with Cooccurring Stress in Experimental Animals

Garabadu

Krishnamurthy

2014

BioMed Research International

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Psychological stress is considered as one of the limiting factors in the management of type-2 diabetes mellitus (T2DM). Therefore, the basic objective of the present study was to evaluate the antidiabetic effect of metformin, diazepam, and their combination in cooccurring T2DM and stress condition (DMS). T2DM was induced in the male rats by administering streptozotocin (45 mg/kg, i.p.) and nicotinamide (110 mg/kg, i.p.) with time lag of 15 min. Rats were subjected to two sessions of cold restraint stress paradigm for one hour on the sixth and seventh day after streptozotocin injection. Administration of metformin (25 mg/kg, p.o.) and diazepam (1 mg/kg, p.o.) in combination from the seventh to thirteenth day after streptozotocin injection showed better improvement in glucose tolerance and insulin sensitivity compared to monotherapy of either drug. In addition, the combination significantly attenuated DMS-induced hyperglycemia, hypertriglyceridaemia, hypercorticosteronemia, anxiety-like behavior, and insulin resistance through modulating insulin signaling pathway in the liver compared to monotherapy. Further, improvement of mitochondrial function, integrity, and oxidative stress in hippocampus, hypothalamus, prefrontal cortex, striatum, amygdala, and nucleus accumbens was observed with the combination. Therefore, metformin in combination with diazepam may be a better therapeutic option in the management of T2DM with cooccurring stress condition.

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Study comparing the effect of pioglitazone in combination with either metformin or sulphonylureas on lipid profile and glycaemic control in patients with type 2 diabetes (ECLA)

Cited by 14 publications

References 48 publications

MARCH2: Comparative Assessment of Therapeutic Effects of Acarbose and Metformin in Newly Diagnosed Type 2 Diabetes Patients

MARCH2: Comparative Assessment of Therapeutic Effects of Acarbose and Metformin in Newly Diagnosed Type 2 Diabetes Patients

Comparison of therapeutic effects of acarbose and metformin under different β-cell function status in Chinese patients with type 2 diabetes

Diazepam Potentiates the Antidiabetic, Antistress and Anxiolytic Activities of Metformin in Type-2 Diabetes Mellitus with Cooccurring Stress in Experimental Animals

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