Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/40144 |
Resumo: | OBJECTIVE: To compare the effects of glimepiride and metformin on vascular reactivity, hemostatic factors and glucose and lipid profiles in patients with type 2 diabetes. METHODS: A prospective study was performed in 16 uncontrolled patients with diabetes previously treated with dietary intervention. The participants were randomized into metformin or glimepiride therapy groups. After four months, the patients were crossed over with no washout period to the alternative treatment for an additional four-month period on similar dosage schedules. The following variables were assessed before and after four months of each treatment: 1) fasting glycemia, insulin, catecholamines, lipid profiles and HbA1 levels; 2) t-PA and PAI-1 (antigen and activity), platelet aggregation and fibrinogen and plasminogen levels; and 3) the flow indices of the carotid and brachial arteries. In addition, at the end of each period, a 12-hour metabolic profile was obtained after fasting and every 2 hours thereafter. RESULTS: Both therapies resulted in similar decreases in fasting glucose, triglyceride and norepinephrine levels, and they increased the fibrinolytic factor plasminogen but decreased t-PA activity. Metformin caused lower insulin and pro-insulin levels and higher glucagon levels and increased systolic carotid diameter and blood flow. Neither metformin nor glimepiride affected endothelial-dependent or endothelial-independent vasodilation of the brachial artery. CONCLUSIONS: Glimepiride and metformin were effective in improving glucose and lipid profiles and norepinephrine levels. Metformin afforded more protection against macrovascular diabetes complications, increased systolic carotid artery diameter and total and systolic blood flow, and decreased insulin levels. As both therapies increased plasminogen levels but reduced t-PA activity, a coagulation process was likely still ongoing. |
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Clinics |
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Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitusTreatmentMetabolic profileVascular reactivityHemostatic factorsType 2 diabetesOBJECTIVE: To compare the effects of glimepiride and metformin on vascular reactivity, hemostatic factors and glucose and lipid profiles in patients with type 2 diabetes. METHODS: A prospective study was performed in 16 uncontrolled patients with diabetes previously treated with dietary intervention. The participants were randomized into metformin or glimepiride therapy groups. After four months, the patients were crossed over with no washout period to the alternative treatment for an additional four-month period on similar dosage schedules. The following variables were assessed before and after four months of each treatment: 1) fasting glycemia, insulin, catecholamines, lipid profiles and HbA1 levels; 2) t-PA and PAI-1 (antigen and activity), platelet aggregation and fibrinogen and plasminogen levels; and 3) the flow indices of the carotid and brachial arteries. In addition, at the end of each period, a 12-hour metabolic profile was obtained after fasting and every 2 hours thereafter. RESULTS: Both therapies resulted in similar decreases in fasting glucose, triglyceride and norepinephrine levels, and they increased the fibrinolytic factor plasminogen but decreased t-PA activity. Metformin caused lower insulin and pro-insulin levels and higher glucagon levels and increased systolic carotid diameter and blood flow. Neither metformin nor glimepiride affected endothelial-dependent or endothelial-independent vasodilation of the brachial artery. CONCLUSIONS: Glimepiride and metformin were effective in improving glucose and lipid profiles and norepinephrine levels. Metformin afforded more protection against macrovascular diabetes complications, increased systolic carotid artery diameter and total and systolic blood flow, and decreased insulin levels. As both therapies increased plasminogen levels but reduced t-PA activity, a coagulation process was likely still ongoing.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2012-07-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/4014410.6061/clinics/2012(07)03Clinics; Vol. 67 No. 7 (2012); 711-717Clinics; v. 67 n. 7 (2012); 711-717Clinics; Vol. 67 Núm. 7 (2012); 711-7171980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/40144/43010Machado, Helena AtrochVieira, MarceloCunha, Maria RosariaCorreia, Marcia Regina SoaresFukui, Rosa TsunechiroSantos, Rosa Ferreira dosRocha, Dalva MarreiroWajchenberg, Bernardo LeoLage, Silvia G.Silva, Maria Elizabeth Rossi dainfo:eu-repo/semantics/openAccess2012-08-23T18:31:14Zoai:revistas.usp.br:article/40144Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2012-08-23T18:31:14Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus |
title |
Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus |
spellingShingle |
Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus Machado, Helena Atroch Treatment Metabolic profile Vascular reactivity Hemostatic factors Type 2 diabetes |
title_short |
Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus |
title_full |
Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus |
title_fullStr |
Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus |
title_full_unstemmed |
Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus |
title_sort |
Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus |
author |
Machado, Helena Atroch |
author_facet |
Machado, Helena Atroch Vieira, Marcelo Cunha, Maria Rosaria Correia, Marcia Regina Soares Fukui, Rosa Tsunechiro Santos, Rosa Ferreira dos Rocha, Dalva Marreiro Wajchenberg, Bernardo Leo Lage, Silvia G. Silva, Maria Elizabeth Rossi da |
author_role |
author |
author2 |
Vieira, Marcelo Cunha, Maria Rosaria Correia, Marcia Regina Soares Fukui, Rosa Tsunechiro Santos, Rosa Ferreira dos Rocha, Dalva Marreiro Wajchenberg, Bernardo Leo Lage, Silvia G. Silva, Maria Elizabeth Rossi da |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Machado, Helena Atroch Vieira, Marcelo Cunha, Maria Rosaria Correia, Marcia Regina Soares Fukui, Rosa Tsunechiro Santos, Rosa Ferreira dos Rocha, Dalva Marreiro Wajchenberg, Bernardo Leo Lage, Silvia G. Silva, Maria Elizabeth Rossi da |
dc.subject.por.fl_str_mv |
Treatment Metabolic profile Vascular reactivity Hemostatic factors Type 2 diabetes |
topic |
Treatment Metabolic profile Vascular reactivity Hemostatic factors Type 2 diabetes |
description |
OBJECTIVE: To compare the effects of glimepiride and metformin on vascular reactivity, hemostatic factors and glucose and lipid profiles in patients with type 2 diabetes. METHODS: A prospective study was performed in 16 uncontrolled patients with diabetes previously treated with dietary intervention. The participants were randomized into metformin or glimepiride therapy groups. After four months, the patients were crossed over with no washout period to the alternative treatment for an additional four-month period on similar dosage schedules. The following variables were assessed before and after four months of each treatment: 1) fasting glycemia, insulin, catecholamines, lipid profiles and HbA1 levels; 2) t-PA and PAI-1 (antigen and activity), platelet aggregation and fibrinogen and plasminogen levels; and 3) the flow indices of the carotid and brachial arteries. In addition, at the end of each period, a 12-hour metabolic profile was obtained after fasting and every 2 hours thereafter. RESULTS: Both therapies resulted in similar decreases in fasting glucose, triglyceride and norepinephrine levels, and they increased the fibrinolytic factor plasminogen but decreased t-PA activity. Metformin caused lower insulin and pro-insulin levels and higher glucagon levels and increased systolic carotid diameter and blood flow. Neither metformin nor glimepiride affected endothelial-dependent or endothelial-independent vasodilation of the brachial artery. CONCLUSIONS: Glimepiride and metformin were effective in improving glucose and lipid profiles and norepinephrine levels. Metformin afforded more protection against macrovascular diabetes complications, increased systolic carotid artery diameter and total and systolic blood flow, and decreased insulin levels. As both therapies increased plasminogen levels but reduced t-PA activity, a coagulation process was likely still ongoing. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-07-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/40144 10.6061/clinics/2012(07)03 |
url |
https://www.revistas.usp.br/clinics/article/view/40144 |
identifier_str_mv |
10.6061/clinics/2012(07)03 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/40144/43010 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 67 No. 7 (2012); 711-717 Clinics; v. 67 n. 7 (2012); 711-717 Clinics; Vol. 67 Núm. 7 (2012); 711-717 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222758716571648 |