Improved glycemic control induced by both metformin and repaglinide is associated with a reduction in blood levels of 3-deoxyglucosone in nonobese patients with type 2 diabetes

Engelen, Lian, Lund, Soren S., Ferreira, Isabel, Tarnow, Lise, Parving, Hans-Henrik, Gram, Jorgen, Winther, Kaj, Pedersen, Oluf, Teerlink, Tom, Barto, Rob, Stehouwer, Coen D. A., Vaag, Allan A. and Schalkwijk, Casper G. (2011) Improved glycemic control induced by both metformin and repaglinide is associated with a reduction in blood levels of 3-deoxyglucosone in nonobese patients with type 2 diabetes. European Journal of Endocrinology, 164 3: 371-379. doi:10.1530/EJE-10-0851


Author Engelen, Lian
Lund, Soren S.
Ferreira, Isabel
Tarnow, Lise
Parving, Hans-Henrik
Gram, Jorgen
Winther, Kaj
Pedersen, Oluf
Teerlink, Tom
Barto, Rob
Stehouwer, Coen D. A.
Vaag, Allan A.
Schalkwijk, Casper G.
Title Improved glycemic control induced by both metformin and repaglinide is associated with a reduction in blood levels of 3-deoxyglucosone in nonobese patients with type 2 diabetes
Journal name European Journal of Endocrinology   Check publisher's open access policy
ISSN 0804-4643
1479-683X
Publication date 2011-03-01
Year available 2011
Sub-type Article (original research)
DOI 10.1530/EJE-10-0851
Open Access Status
Volume 164
Issue 3
Start page 371
End page 379
Total pages 9
Place of publication Woodlands, Bristol, United Kingdom
Publisher BioScientifica
Language eng
Abstract Objective: Metformin has been reported to reduce α-dicarbonyls, which are known to contribute to diabetic complications. It is unclear whether this is due to direct quenching of α-dicarbonyls or to an improvement in glycemic control. We therefore compared the effects of metformin versus repaglinide, an antihyperglycemic agent with an insulin-secreting mechanism, on the levels of the α-dicarbonyl 3-deoxyglucosone (3DG). Methods: We conducted a single-center, double-masked, double-dummy, crossover study involving 96 nonobese patients with type 2 diabetes. After a 1-month run-in on diet-only treatment, patients were randomized to either repaglinide (6 mg daily) followed by metformin (2 g daily) or vice versa each during 4 months with a 1-month washout between interventions. Results: 3DG levels decreased after both metformin (-19.3% (95% confidence interval (CI): -23.5, -14.8)) and repaglinide (-20.8% (95% CI: -24.9, -16.3)) treatments, but no difference was found between treatments (1.8% (95% CI: -3.8, 7.8)). Regardless of the treatment, changes in glycemic variables were associated with changes in 3DG. Specifically, 3DG decreased by 22.7% (95% CI: 19.0, 26.5) per S.D. decrease in fasting plasma glucose (PG), by 20.0% (95% CI: 16.2, 23.9) per S.D. decrease in seven-point mean plasma glucose, by 22.5% (95% CI: 18.6, 26.6) per S.D. decrease in area under the curve for PG, by 17.2% (95% CI: 13.8, 20.6) per S.D. decrease in HbAlc, and by 10.9% (95% CI: 6.4, 15.5) per S.D. decrease in Amadori albumin. In addition, decreases in 3DG were associated with decreases in advanced glycation endproducts and endothelial markers. Conclusion: Improved glycemic control induced by both metformin and repaglinide is associated with a reduction in 3DG levels in nonobese individuals with type 2 diabetes. This may constitute a shared metabolic pathway through which both treatments have a beneficial impact on the cardiovascular risk.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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Created: Wed, 20 May 2015, 16:35:01 EST by Isabel Ferreira on behalf of School of Public Health