Contrasting Three Non-hypoglycemic Antidiabetic Drug Effects on Glycemic Control in Newly Diagnosed Type II Diabetes Mellitus: An Experimental Study

Authors

  • Abdulhamza Hmood Department of Medicine, College of Medicine, University of Karbala, Karbala, Iraq
  • Mohammed Almasoody Department of Medicine, College of Medicine, University of Babylon, Babil, Iraq
  • Hameed Hussein Al-Jameel Department of Medicine, College of Medicine, University of Karbala, Karbala, Iraq https://orcid.org/0000-0002-5390-4746

DOI:

https://doi.org/10.3889/oamjms.2022.8631

Keywords:

Non-hypoglycemic, Antidiabetic drug, Glycemic control, Newly diagnosed type II diabetes mellitus

Abstract

BACKGROUND: Diabetes mellitus (DM) type 2 is the most public chronic, metabolic illness whose prevalence is quickly becoming high international. Insulin resistance, the essential metabolic problem leads to the development of DM type 2, is seen in about 90% of patients.

AIM: The study’s aim was to compare the efficacy of three antidiabetic drugs on glycated hemoglobin.

METHOD: A cross-sectional comparative study for newly diagnosed type II diabetic patients were assigned randomly into one of three conditions: Group I: Metformin consuming patients, Group II: Pioglitazone consuming patients, and Group III: Vildagliptin consuming patients. All patients were newly diagnosed. For all of them, baseline glycated hemoglobin was requested. After that, random assignment was carried out. After 3 months, glycated hemoglobin was checked and compared.

RESULTS: Participants were distributed randomly into 27.9% metformin taking participants, 31.1% pioglitazone taking, and 41% vildagliptin taking patient. Findings suggested significant difference between Groups I and III (p =). Likewise, significant difference was seen between Groups II and III (p =). However, Groups I and II have comparable effects (p =). Indeed, all groups had shown significant efficacy on HbA1c.

CONCLUSION: Metformin, pioglitazone, and vildagliptin had shown significant impact on HbA1c with variable degree: Metformin and pioglitazone had shown comparably similar efficacy that was exerted more significant impact on HbA1c than vildagliptin does.

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References

Alam F, Islam MA, Mohamed M, Ahmad I, Kamal MA, Donnelly R, et al. Efficacy and safety of pioglitazone monotherapy in Type 2 diabetes mellitus: A systematic review and meta-analysis of randomised controlled trials. Sci Rep. 2019;9(1):5389. http://doi.org/10.1038/s41598-019-41854-2 PMid:30926892 DOI: https://doi.org/10.1038/s41598-019-41854-2

Yildiz BO, Yarali H, Oguz H, Bayraktar M. Glucose intolerance, insulin resistance, and hyperandrogenemia in first degree relatives of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88(5):2031-6. http://doi.org/10.1210/jc.2002-021499 PMid:12727950 DOI: https://doi.org/10.1210/jc.2002-021499

American Diabetes Association. 8. Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes-2018. Diabetes Care. 2018;41 Suppl 1:S73-85. http://doi.org/10.2337/dc18-S008 PMid:29222379 DOI: https://doi.org/10.2337/dc18-S008

Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in Type 2 diabetes. N Engl J Med. 2008;359(15):1577-89. http://doi.org/10.1056/NEJMoa0806470 PMid:18784090 DOI: https://doi.org/10.1056/NEJMoa0806470

Sivitz WI, Phillips LS, Wexler DJ, Fortmann SP, Camp AW, Tiktin M, et al. Optimization of metformin in the GRADE cohort: Effect on glycemia and body weight. Diabetes Care. 2020;43(5):940-7. http://doi.org/10.2337/dc19-1769 PMid:32139384 DOI: https://doi.org/10.2337/dc19-1769

Pioglitazone Oral: Uses, Side Effects, Interactions, Pictures, Warnings and Dosing-WebMD; 2022. Available from: https://www.webmd.com/drugs/2/drug-17406/pioglitazone-oral/details [Last accessed on 2022 Jan 5].

Ahrén B, Schweizer A, Dejager S, Villhauer EB, Dunning BE, Foley JE. Mechanisms of action of the dipeptidyl peptidase-4 inhibitor vildagliptin in humans. Diabetes Obes Metab. 2011;13(9):775-83. http://doi.org/10.1111/j.1463-1326.2011.01414.x PMid:21507182 DOI: https://doi.org/10.1111/j.1463-1326.2011.01414.x

Keating GM. Vildagliptin: A review of its use in Type 2 diabetes mellitus. Drugs. 2010;70(16):2089-112. http://doi.org/10.2165/11206370-000000000-00000 PMid:20964454 DOI: https://doi.org/10.2165/11206370-000000000-00000

Thornberry NA, Gallwitz B. Mechanism of action of inhibitors of dipeptidyl-peptidase-4 (DPP-4). Best Pract Res Clin Endocrinol Metab. 2009;23(4):479-86. http://doi.org/10.1016/j.beem.2009.03.004 PMid:19748065 DOI: https://doi.org/10.1016/j.beem.2009.03.004

Pan C, Xing X, Han P, Zheng S, Ma J, Liu J, et al. Efficacy and tolerability of vildagliptin as add-on therapy to metformin in Chinese patients with Type 2 diabetes mellitus. Diabetes Obes Metab. 2012;14(8):737-44. http://doi.org/10.1111/j.1463-1326.2012.01593.x PMid:22369287 DOI: https://doi.org/10.1111/j.1463-1326.2012.01593.x

Genovese S, de Berardis G, Nicolucci A, Mannucci E, Evangelista V, Totani L, et al. Effect of pioglitazone versus metformin on cardiovascular risk markers in Type 2 diabetes. Adv Ther. 2013;30(2):190-202. http://doi.org/10.1007/s12325-013-0003-x PMid:23359066 DOI: https://doi.org/10.1007/s12325-013-0003-x

Charbonnel BH, Matthews DR, Schernthaner G, Hanefeld M, Brunetti P. A long-term comparison of pioglitazone and gliclazide in patients with Type 2 diabetes mellitus: A randomized, double-blind, parallel-group comparison trial. Diabet Med. 2005;22(4):399-405. http://doi.org/10.1111/j.1464-5491.2004.01426.x PMid:15787663 DOI: https://doi.org/10.1111/j.1464-5491.2004.01426.x

Erem C, Ozbas HM, Nuhoglu I, Deger O, Civan N, Ersoz HO. 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. Exp Clin Endocrinol Diabetes. 2014;122(5):295-302. http://doi.org/10.1055/s-0034-1370989 PMid:24710641 DOI: https://doi.org/10.1055/s-0034-1370989

Kim NH, Kim DL, Kim KJ, Kim NH, Choi KM, Baik SH, et al. Effects of vildagliptin or pioglitazone on glycemic variability and oxidative stress in patients with Type 2 diabetes inadequately controlled with metformin monotherapy: A 16-week, randomised, open label, pilot study. Endocrinol Metab (Seoul). 2017;32(2):241-7. http://doi.org/10.3803/EnM.2017.32.2.241 PMid:28685513 DOI: https://doi.org/10.3803/EnM.2017.32.2.241

Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycemia in Type 2 diabetes: A patient-centered approach: Position statement of the American diabetes association (ADA) and the European association for the study of diabetes (EASD). Diabetes Care. 2012;35(6):1364-79. http://doi.org/10.2337/dc12-0413 PMid:22517736 DOI: https://doi.org/10.2337/dc12-1184

Hemmingsen B, Sonne DP, Metzendorf MI, Richter B. Insulin secretagogues for prevention or delay of Type 2 diabetes mellitus and its associated complications in persons at increased risk for the development of Type 2 diabetes mellitus. Cochrane database Syst Rev. 2016;10(10):CD012151. http://doi.org/10.1002/14651858.CD012151.pub2 PMid:27749986 DOI: https://doi.org/10.1002/14651858.CD012151

Phung OJ, Sobieraj DM, Engel SS, Rajpathak SN. Early combination therapy for the treatment of Type 2 diabetes mellitus: Systematic review and meta-analysis. Diabetes Obes Metab. 2014;16(5):410-7. http://doi.org/10.1111/dom.12233 PMid:24205921 DOI: https://doi.org/10.1111/dom.12233

Man CD, Bock G, Giesler PD, Serra DB, Saylan ML, Foley JE, et al. Dipeptidyl peptidase-4 inhibition by vildagliptin and the effect on insulin secretion and action in response to meal ingestion in Type 2 diabetes. Diabetes Care. 2009;32(1):14-8. http://doi.org/10.2337/dc08-1512 PMid:18931099 DOI: https://doi.org/10.2337/dc08-1512

Rosenstock J, Baron MA, Dejager S, Mills D, Schweizer A. Comparison of vildagliptin and rosiglitazone monotherapy in patients with Type 2 diabetes: A 24-week, double-blind, randomized trial. Diabetes Care. 2007;30(2):217-23. http://doi.org/10.2337/dc06-1815 PMid:17259484 DOI: https://doi.org/10.2337/dc06-1815

Cohen CM, Davis C, Shalev V, Chodick G. Effectiveness of vildagliptin as add-on to metformin monotherapy among uncontrolled Type 2 diabetes mellitus patients in a real-world setting. J Diabetes. 2018;10(1):68-72. http://doi.org/10.1111/1753-0407.12560 PMid:28418203 DOI: https://doi.org/10.1111/1753-0407.12560

Schweizer A, Couturier A, Foley JE, Dejager S. Comparison between vildagliptin and metformin to sustain reductions in HbA(1c) over 1 year in drug-naïve patients with Type 2 diabetes. Diabet Med. 2007;24(9):955-61. http://doi.org/10.1111/j.1464-5491.2007.02191.x PMid:17509069 DOI: https://doi.org/10.1111/j.1464-5491.2007.02191.x

Liu SC, Chien KL, Wang CH, Chen WC, Leung CH. Efficacy and safety of adding pioglitazone or sitagliptin to patients with Type 2 diabetes insufficiently controlled with metformin and a sulfonylurea. Endocr Pract. 2013;19(6):980-8. http://doi.org/10.4158/EP13148.OR PMid:23807528 DOI: https://doi.org/10.4158/EP13148.OR

Scheen AJ. Diabetes mellitus in the elderly: Insulin resistance and/or impaired insulin secretion? Diabetes Metab. 2005;31 Spec No 2:5S27-34. http://doi.org/10.1016/s1262-3636(05)73649-1 PMid:16415763 DOI: https://doi.org/10.1016/S1262-3636(05)73649-1

Chawla S, Kaushik N, Singh NP, Ghosh RK, Saxena A. Effect of addition of either sitagliptin or pioglitazone in patients with uncontrolled Type 2 diabetes mellitus on metformin: A randomized controlled trial. J Pharmacol Pharmacother. 2013;4(1):27-32. http://doi.org/10.4103/0976-500X.107656 PMid:23662021 DOI: https://doi.org/10.4103/0976-500X.107656

Skelly AC, Dettori JR, Brodt ED. Assessing bias: The importance of considering confounding. Evid Based Spine Care J. 2012;3(1):9. http://doi.org/10.1055/s-0031-1298595 PMid:23236300 DOI: https://doi.org/10.1055/s-0031-1298595

Manson JE, Shufelt CL, Robins JM. The potential for postrandomization confounding in randomized clinical trials. JAMA. 2016;315(21):2273-4. http://doi.org/10.1001/jama.2016.3676 PMid:27272576 DOI: https://doi.org/10.1001/jama.2016.3676

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Published

2022-02-17

How to Cite

1.
Hmood A, Almasoody M, Al-Jameel HH. Contrasting Three Non-hypoglycemic Antidiabetic Drug Effects on Glycemic Control in Newly Diagnosed Type II Diabetes Mellitus: An Experimental Study. Open Access Maced J Med Sci [Internet]. 2022 Feb. 17 [cited 2024 Apr. 25];10(B):506-10. Available from: https://oamjms.eu/index.php/mjms/article/view/8631