In addition to the equivalent efficacy of rosiglitazone for glycemic control in type 2 diabetes seems to be lower during treatment with vildagliptin the likelihood of weight gain.
The natural glucagon-like peptide-1 (GLP-1), which is formed in the intestine, increases glucose-dependent insulin release. It is with GLP-1 analogues (incretin mimetics) and DPP-4 inhibitor two substance groups that are already used in clinical trials in diabetes. Vildagliptin is a DPP-4 inhibitor and blocks the enzyme DPP IV (dipeptidyl peptidase IV), which normally inactivated in the gut GLP-1. In the mirror from the GLP-1 peptide is increased.
Dr. Julio Rosenstock from the Dallas Diabetes and Endocrine Center in Texas, and colleagues compared (100mg daily) in 786 untreated type 2 diabetic efficiency and tolerability of vildagliptin monotherapy vs. Rosiglitazone (8 mg daily).
Baseline HbA1c values were on average 8.7%. Vildagliptin was registered after 24 weeks, a 1.1% reduction in HbA1c levels (maximum at week 12), for rosiglitazone by 1.3% (maximum in week 16).
Treatment with vildagliptin was associated with a stable body weight, triglycerides, LDL and non-HDL levels were reduced significantly as compared with rosiglitazone. The weight gain with rosiglitazone was on average 1.6 kg.
Vildagliptin was generally well tolerated, with one patient in each of the two treatment groups, a hypoglykömische Episode observed, the incidence of edema was higher with rosiglitazone (4.2% vs. 2.1%).
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