Bao YQ, Zhou J, Zhou M, Cheng YJ, Lu W, Pan XP, Tang JL, Lu HJ, Jia WP.
Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
SUMMARY 1. The aim of the present study was to use continuous glucose monitoring system (CGMS) to investigate the effect of glipizide controlled-release (CR) tablets monotherapy or glipizide CR tablets plus acarbose on glycemic variability in newly diagnosed type 2 diabetes (T2DM) patients. 2. Forty newly diagnosed T2DM patients whose glycated hemoglobin A(1c) (HbA(1c)) levels ranged from 7.0% to 9.8% were randomized to either monotherapy with glipizide CR tablets or combination therapy with glipizide CR tablets and acarbose for 8 weeks. Overall glycemic control and blood glucose variability were evaluated by CGMS parameters. 3. After an 8-week treatment period, fasting and postprandial blood glucose, HbA(1c), glycated albumin (GA), mean blood glucose, mean amplitude of glycemic excursions (MAGE), postprandial incremental area under the curve (AUCpp) and homeostasis model assessment-insulin resistance decreased significantly in both study groups (p<0.01). There was also a significant decrease in means of daily differences (MODD) in the combination therapy group. The mean changes of MBG, MAGE, MODD, and AUCpp were significantly greater in the combination therapy group than in the monotherapy group (all p<0.01), while no significant differences were found in the mean changes of HbA(1c) and GA. Multivariate regression analysis showed that the decrement in AUCpp was significantly associated with decreases in MAGE. 4. In conclusion, glipizide CR tablets alone or in combination with acarbose could improve overall blood glucose levels and glycemic variability. Combination therapy of glipizide CR tablets with acarbose was more effective in reducing intra-day and day-to-day glycemic variability than glipizide CR tablets monotherapy.
PMID: 20082624
