Endocrine Abstracts

Background and aims: Combination of drugs, affecting early insulin secretion and peripheral insulin resistance are a good therapeutic option for patients (pts) with type 2 diabetes mellitus (T2DM). The aim of the present work was to compare efficacy of Repaglinide+Metformin and Sulphonilurea+Metformine in obese T2DM pts.

Materials and methods: A total of 107 pts with T2DM not well-controlled on monotherapy. Repaglinide - naïve were allocated into 2 groups (Gr.): Gr 1 (n=65) – Repaglinide 1 mg/meal and Metformin 1000 mg twice/daily. Gr.2 (n=42) – Glimepiride 4 mg/breakfast and Metformin1000 mg twice/daily. At entry following data were obtained for Gr.1 and Gr.2, respectively: age – 56.9±9.7 and 54.6±6.9 yrs; diabetes duration – 4.18± 2.06 and 4.04 ±3.1 yrs; BMI – 28.9± 5.3 and 29.1± 4.9 kg/m2; HbA1c – 10.43±2.46 and 9.72±2.72%; fasting glycemia (FG) – 195.5±59.5 and 158.3±83.2 mg/dl; postprandial glycemia (PG) – 285.6±91.17 and 220.1±91.64 mg/dl. Pts were supervised for 3 months.

Results: Examinations at month 3 post treatment initiation revealed: BMI decreased to 26.1±4.2 kg/m2; P=0.001 (Gr.1) and 28.8±5.1 kg/m2; P=0.784 (Gr.2); HbA1c dropped to 6.94±1.11%; P=0.000 (Gr.1) and 7.99±1.46%; P=0.000 (Gr.2). HbA1c values decreased by 3.49±1.35% (Gr.1) and 1.73± 1.26% (Gr.2). FG decreased to 114.6 ± 19.7 mg/dl; P=0.000 (Gr.1) and 138.8±50.2 mg/dl; P=0.197 (Gr.2); PG dropped to 123.3±24.18 mg/dl; P=0.000(Gr.1) and 178.6±43.9 mg/dl; P=0.01 (Gr.2). The latter values decreased by 162.3±66.99 mg/dl (Gr.1) and 41.5±17.74 mg/dl (Gr.2). Analysis of the data obtained revealed statistically evident positive shifts in BMI, HbA1c, FG, PG.

Conclusion: These data confirm that Repaglinide+Metformin gives rapid effect in reducing glycemia (FG, PG), HbA1c and BMI indices in T2DM pts.