α-Glucosidase inhibitor reduces the progression of carotid intima-media thickness

Yamasaki, Yoshimitsu; Katakami, Naoto; Hayaishi-Okano, Rieko; Matsuhisa, Munehide; Kajimoto, Yoshitaka; Kosugi, Ken’ichirou; Hatano, M; Hori, Masatsugu

doi:10.1016/j.diabres.2004.07.012

Cited by 57 publications

(36 citation statements)

References 18 publications

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“…The number of patients treated was based on the assumption of a change of 0.022 mm in the non-pioglitazone group, whereas the actual differences were 0.031 and 0.043 mm. This significant decrease even in the non-pioglitazone group possibly reflects the more frequent use of biguanides and -glucosidase inhibitors in the non-pioglitazone group 24,25) . Interestingly, the findings of this substudy mirror the results of the "parent" PROBE trial, which also found a non-significant trend towards improved macrovascular outcomes in the pioglitazone group versus the control group 15) .…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Yamasaki¹,

Katakami²,

Furukado³

et al. 2010

JAT

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Aim:No previous studies have evaluated the long-term anti-atherosclerotic effects of pioglitazone in Asian patients with type 2 diabetes. Therefore, the present study investigated the protective effects of pioglitazone on the progression of carotid intima-media thickness (IMT), an established surrogate marker of cardiovascular events in Japanese type 2 diabetic patients without a recent history of cardiovascular morbidity. Methods: This 2.5 − 4-year, randomized, open-label, blinded endpoint study was conducted in 6 centers across Japan. Patients received pioglitazone with or without other oral glucose-lowering drugs (excluding another thiazolidinedione) (n 89) or oral glucose-lowering drugs, excluding thiazolidinediones (n 97). Treatment was adjusted to achieve HbA1c 6.5%. The primary endpoints of the study were the absolute changes from the baseline to final visit in max-and mean-IMT in the average of bilateral common carotid arteries.

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Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Yamasaki¹,

Katakami²,

Furukado³

et al. 2010

JAT

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“…The annual increase rate of IMT adjusted for other clinical factors was significantly smaller in A group than in D group, and it was actually a negative value in A group, meaning that regression of IMT from the baseline was achieved by near normalization of HbA1c level for three years. Pioglitazone, metformin and a-glucosidase inhibitor, voglibose, were previously reported to reduce the IMT increase independently of glycemic control in type 2 diabetic patients [11][12][13]. While these oral agents having extra-pancreatic actions did not differ between the two groups, the proportion of the patients with insulin secretagogue (sulfonylurea or nateglinide) was significantly lower in A group than in D group (12% vs. 43%, c 2 = 9.71, p = 0.002) as shown in Table 3.…”

Section: Discussionmentioning

confidence: 99%

Strict Glycemic Control Ameliorates the Increase of Carotid IMT in Patients with Type 2 Diabetes

et al. 2006

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Abstract. The aim of this study was to investigate the effect of strict glycemic control on the carotid artery intima-media thickness (IMT) in type 2 diabetic patients who initially had good glycemic control (HbA1c between 5.8 and 6.4 %). The subjects were 67 patients showing deterioration of the mean HbA1c over 3 years by more than 0.2% from baseline (D group) and 33 subjects showing improvement of the mean HbA1c by more than 0.2% from baseline (A group). The clinical characteristics and annual change of IMT during the observation period were compared between the two groups in a 3-year retrospective longitudinal study. The baseline characteristics and the mean values of BMI, blood pressure, and serum lipids during the study period did not differ significantly between the two groups. However, the mean HbA1c of A group was significantly lower than that of D group (5.67 ± 0.10 vs. 6.28 ± 0.08, mean ± SE, p<0.001). The adjusted annual increase rate of IMT was significantly less in A group than in D group (-0.035 ± 0.019 vs. 0.036 ± 0.015 mm, M ± SEM, p<0.001). These results indicate that further improvement of glycemic control from a good HbA1c value can prevent an increase of IMT in type 2 diabetic patients. IT is well-known that the onset and progression of atherosclerosis is much more rapid in diabetic patients than healthy non-diabetic subjects, and one of the major causes of death in diabetes is atherosclerotic diseases. Thus, strict glycemic control is important to prevent the onset and progression of atherosclerosis. The UK Prospective Diabetes Study (UKPDS), a largescale prospective study of newly diagnosed type 2 diabetic patients, showed that every 1% decrease of HbA1c could reduce the incidence of myocardial infarction and stroke by 14% and 11%, respectively [1]. However, the UKPDS failed to show a significant reduction in the incidence of stroke and myocardial infarction in the intensive glycemic control group (median HbA1c: 7.0%) compared with the conventional glycemic control group (median HbA1c: 7.9%) over 15 years [2]. These results suggest that much stricter glycemic control and an HbA1c below 7.0% may be needed to prevent atherosclerosis in diabetic patients. The Japan Diabetes Society (JDS) had proposed an HbA1c from 5.8% to 6.4% as a marker of good control, with less than 5.7% as excellent control. However, there is no evidence as to whether the risk of atherosclerosis can be decreased by further reducing HbA1c levels from the good control range (5.8-6.4%) to the excellent range (£5.7%) in Japanese type 2 diabetic patients. Therefore, many diabetic patients with good control are maintained at such HbA1c levels, and no attempts are made to achieve excellent control. We previously reported a method of measuring carotid artery intima-media thickness (IMT) by B-mode ultrasonography and showed that the IMT of subjects with diabetes was larger than that of age-matched subjects with normal glucose tolerance [3,4]. Previous

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“…Treatment with voglibose, an ␣-glucosidase inhibitor, reduced the progression of CIMT. 42 Although postprandial glucose levels were not evaluated in the study, a significant linear relationship between annual changes of CIMT and mean HbA 1c levels during the follow-up was seen. CIMT progressed by 0.0137 mm/y per 1% increase of HbA 1c .…”

Section: Blood Glucose-lowering Agentsmentioning

confidence: 99%

Recent Advances of Intervention to Inhibit Progression of Carotid Intima-Media Thickness in Patients With Type 2 Diabetes Mellitus

Yokoyama

Katakami

Yamasaki

2006

Stroke

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Background and Purpose-Type 2 diabetes is associated with a high cardiovascular morbidity and mortality. Recent advances of intervention studies in type 2 diabetes with use of carotid intima-media thickness (CIMT) measurement as a surrogate end point may allow for better understanding of the undetermined process of atherosclerosis, the effect of interventions, and the usefulness of CIMT to inhibit events of cardiovascular disease. Summary of Review-Data were available from 11 studies (nϭ1578) in subjects with type 2 diabetes (including impaired glucose tolerance, nϭ132) that evaluated the effect of interventions on change in CIMT. The overall weighed rate of change in mean CIMT based on data among control groups (ie, type 2 diabetes without interventions) was 0.034 mm/y (95% CI, 0.029 to 0.039; median SD, 0.054), in which mean HbA 1c was 7.86% (95% CI, 7.72 to 8.00; median SD, 1.5). A significant close correlation of HbA 1c with rate of CIMT change was found (R 2 ϭ0.35, Pϭ0.01). Agents for lowering of blood glucose, platelet activation, or blood pressure significantly reduced the CIMT increase, independent of blood glucose control. This implies that other mechanisms of such agents to diminish CIMT increase should be explored. Conclusions-CIMT measurement may contribute to elucidating the short-and/or long-term effect of interventions on the rate of change in CIMT in relation to the levels of various risk factors. Although the method needs further standardization, pharmacological interventions are likely to inhibit progression of CIMT, leading to a reduction of cardiovascular events.

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α-Glucosidase inhibitor reduces the progression of carotid intima-media thickness

Cited by 57 publications

References 18 publications

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Strict Glycemic Control Ameliorates the Increase of Carotid IMT in Patients with Type 2 Diabetes

Recent Advances of Intervention to Inhibit Progression of Carotid Intima-Media Thickness in Patients With Type 2 Diabetes Mellitus

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