Estudo comparativo dos efeitos vildagliptina e da gliclazida sobre o perfil lipídico e estresse oxidativo de diabéticos inadequadamente controlados por metformina

• Autor(a) principal: Hissa, Marcelo Rocha Nasser
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/13660
• topic: Diabetes; Gliclazida; Glicemia

Diabetes is closely linked to coronary artery disease either through direct effects of hyperglycemia, or indirectly, by its frequent association with the metabolic syndrome. Any treatment for diabetes that aims beyond the ability to reduce glycated hemoglobin, improve lipid profiles and weight reduction will bring many benefits to patients. The present study aimed to compare the effects of vildagliptin with gliclazide on lipid profile and oxidative stress in diabetic patients using metformin with inadequate glycemic control. A prospective study of 22 weeks were conducted with diabetic patients using metformin without adequate glycemic control. Patients were randomized to receive gliclazide 60 mg / day or vildagliptin 100 mg / day. 36 patients were randomized in the study. 18 were selected for treatment with vildagliptin 100mg and 18 for gliclazide 90mg daily. Regarding the lipid profile the only difference observed at the end of the study was higher HDL in the vildagliptin group compared with gliclazide fasting (62.3 vs. 51.3 mg / dL, p = 0.021) and postprandial (62.9 vs. 51.1 mg / dL, p = 0.015). We also observed a variation of negative weight (decrease the end compared to the beginning) of the vildagliptin and a positive (increase) in the gliclazide (-0.3 vs. +1.4 Kg, p = 0.048). The decrease in HbA1c was lower in the vildagliptin group compared to gliclazide (-1.7 vs. -2.3%, P = 0.031), however there was no difference in the number of patients reaching target glycated hemoglobin <7% (50 vs. 61.1%, p = 0.738). Only the group of vildagliptin presented at the end of the study compared to the beginning, decreased insulin values (599.6 vs.705, 59 pg / ml, p = 0.021), glucagon (46.6 vs.65, 2 pg / ml, p = 0.004) and the marker of oxidative stress TBAR (8.0 vs. 9.0 nmol MDA / ml, p = 0.035). In conclusion vildagliptin demonstrated additional advantages over gliclazide for patients inadequately treated with metformin. Patients treated with vildagliptin had a higher HDL at the end of the study, less variance in weight, reduced insulin and glucagon as well as reduction of oxidative stress shown by lower TBAR marker.