Τομέας ΠαθολογίαςLibrary of the School of Health Sciences
Καθηγητής Σ. Λαδάς, Αναπληρωτής Καθηγητής Ν. Τεντολούρης, Αναπληρωτής Καθηγητής Κ. Μακρυλάκης
Σύγκριση της επίδρασης της σιταγλιπτίνης και της μετφορμίνης στα επίπεδα των πεπτιδίων που ρυθμίζουν την όρεξη σε ασθενείς με διαβήτη τύπου 2
Objective: To investigate the effect of sitagliptin and metformin on the gut
peptide levels and on the glucose and lipid profiles in patients with type 2
Materials and methods: Thirty one patients with newly diagnosed type 2 diabetes
participated in this study and were allocated to two groups. One group [mean
age: 59.5 ± 10.5 years, BMI: 33.4 ± 6.1 kg/m²] was started on metformin (850 mg
daily) and the other group [mean age: 58.1 ± 7.9 years, BMI: 31.8 ± 8.1 kg/m²]
was started on sitagliptin (100 mg daily) for four weeks. Patients received a
test meal of mixed content and caloric value of 697 Kcal after an overnight
fast, at baseline and four weeks after the treatment. The levels of ghrelin,
GLP-1, GIP, PYY, insulin and glucose were measured before the meal initiation
and 30, 60, 90, 120, 180, 240, 300, 360 minutes post-prandially. Lipid levels
were measured at fasting state and 2, 4 and 6 hours post-prandially.
Results: There was a significant reduction of glycated haemoglobin in both
study groups four weeks after treatment initiation. In the metformin group,
fasting HDL-C was higher at week 4. In the sitagliptin group, fasting glucose
levels were significantly lower while fasting PYY and GLP-1 levels were
significantly higher four weeks after treatment initiation.
In the metformin group, there was a trend for higher post-prandial levels of
HDL-C and lower post-prandial levels of insulin at week 4. In the sitagliptin
group, there was a trend for lower post-prandial glucose levels while the
post-prandial levels of HDL-C and GLP-1 were significantly higher at week 4.
The two study groups displayed statistically significant difference in the
post-prandial levels of GLP-1 four weeks after treatment initiation.
Conclusion: Both sitagliptin and metformin are equally effective on fasting and
post-prandial glucose control since they exert similar effect on the values of
glycated haemoglobin in patients with type 2 diabetes. The administration of
sitagliptin results in lower fasting glucose levels and higher post-prandial
levels of HDL-C as well as in higher levels of fasting PYY and both fasting and
postprandial GLP-1 compared to the administration of metformin four weeks after
the treatment initiation.
Sitagliptin, Metformin, Incretins, GLP-1, PYY
Number of references:
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