Comparative evaluation of voglibose versus pioglitazone on glycaemic control and lipid profile in patients of type 2 diabetes mellitus on glimepiride and metformin in punjabi population

Authors

  • Amita Jindal Department of Pharmacology, Sri Guru Ram Das Institute of Medical sciences and Research, Amritsar, India
  • Meenakshi Gupta Department of Pharmacology, Sri Guru Ram Das Institute of Medical sciences and Research, Amritsar, India
  • Geeta Sharma Department of Pharmacology, Sri Guru Ram Das Institute of Medical sciences and Research, Amritsar, India
  • Gurinder Mohan Department of Medicine, Sri Guru Ram Das Institute of Medical sciences and Research, Amritsar, India
  • Deepika Tikoo Department of Pharmacology, Sri Guru Ram Das Institute of Medical sciences and Research, Amritsar, India

Keywords:

Diabetes mellitus, Voglibose, Pioglitazone

Abstract

Background: Type 2 Diabetes mellitus (DM) is a heterogeneous group of disorders associated with both microvascular and macrovascular complications. Due to progressive nature of type 2 DM, dual / triple drug therapy produce additive effects, less side effects and allows the use of submaximal doses of individual agents. Therefore, the present study was designed to study the effect of voglibose in comparison to pioglitazone on glycaemic and lipid profile as an add-on drug in patients with DM whose glycaemic status was uncontrolled with glimepiride and metformin.

Methods: The present study was open, randomized parallel group comparison of two active treatment groups over a six months period. Sixty patients of either sex in the age group of 30-75 years, suffering from type 2 DM, with FBG> 126 mg/dl and HbA1c between 7- 10 % were selected at random. The effect of voglibose and pioglitazone were observed on various parameters i.e. FBG, PPBG, HbA1c and lipid profile (Total cholesterol, TG, LDL, VLDL).

Results: At the end of 6 months it was observed that though both pioglitazone and voglibose reduced FBG, PPBG and HbA1C significantly but pioglitazone caused a significantly greater percentage change in FBG as well as in PPBG whereas the difference in mean percentage change in HbA1C was not significant. Also, fall in total cholesterol, TG, LDL and VLDL was significantly greater with pioglitazone than voglibose. Few side effects were observed with voglibose and not with pioglitazone.

Conclusions: Though pioglitazone and voglibose were equally effective in lowering HbA1C levels yet pioglitazone showed better results in improving FBG, PPBG and lipid profile as compared to voglibose. Pioglitazone had minimal side effects as compared to voglibose.

References

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates and projections. Diabetes Care 1998;21:1414-31.

Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res 2007;125:217-30.

Zafar J, Bhatti F, Akhtar N, Rasheed U, Humayun S, Waheed A et al. Prevalence and risk factors for diabetes mellitus in a selected urban population of a city in Punjab. J Pak Med Assoc 2011;61:40-7.

Nathan DM, Meigs J, Singer DE. The epidemiology of cardiovascular disease in type 2 diabetes mellitus: how sweet it is...or is it? Lancet 1997;350 Suppl 1:S14-9.

Hu FB, Manson JE, Stampfer MJ. Diet, Lifestyle and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001;345:790-7.

United Kingdom Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998;317:703-13.

Guillausseau PJ, Massin P, Charles MA et al. Glycaemic control and development of retinopathy in type 2 diabetes mellitus: a longitudinal study. Diabetes Med 1998;15:151-5.

Grundy SM. Dietary therapy in diabetes mellitus. Diabetes Care 1991;14:796-801.

Powers AC. Diabetes Mellitus. In: Fauci AS, Braunwald E, Kasper DL, Stephen LH, Dan LL, Jameson LL, Loscalzo J, eds. Harrison’s principles of internal medicine. 17th ed. New York: Mc Graw Hill; 2008:2275-304.

Tripathi KD. Insulin, oral hypoglycaemic drugs and glucagon. In: Tripathi KD. Essentials of medical pharmacology. 6th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2008:254-74.

Bailey CJ, Turner RC. Metformin. N Engl J Med 1996;334:574-9.

Mudaliar S. New frontiers in the management of type 2 diabetes. Indian J Med Res 2007;125:275-96.

Lebovitz HE. Insulin resistance: definition and consequences. Exp Clin Endocrinol Diabetes 2001;109 Suppl 2:S135-48.

Inzucchi SE. Oral antihyperglycemic therapy for type 2 diabetes: scientific review. JAMA 2002;287:360-72.

Costa B, Pinol C. Acarbose in ambulatory treatment of non-insulin-dependent diabetes mellitus associated to imminent sulfonylurea failure: a randomised-multicentric trial in primary health-care. Diabetes and Acarbose Research Group. Diabetes Res Clin Pract 1997; 38:33-40.

Shinozaki K, Suzuki M, Hirose J, Hara Y, Harano Y. Improvement of insulin sensitivity and dyslipidemia with a new glucosidase inhibitor, Voglibose in nondiabetic hyperinsulinemic subjects. Metabolism 1996;45:731-7.

Roberts VL, Stewart J, Issa M, Lake B, Melis R. Triple drug therapy with glimepride in patients with type 2 diabetes mellitus inadequately controlled by metformin and a thiazolidinedione. Clin Ther 2005;27:1535-47.

Derosa G, Salvedeo SA, D’Angelo A, Ferrari I, Moreu R, Palumbo I et al. Metabolic effect of repaglinide or acarbose when added to a double oral antidiabetic treatment with sulphonylureas and metformin: a double blind, cross over, clinical trial. Curr Med Res Opin. 2009;25:607-15.

Olansky L, Marchatti A, Lau H. Multicenter retrospective assessment of thiazolidinedione monotherapy and combination therapy in patients with type 2 diabetes mellitus: comparative subgroup analyses of glycaemic control and blood lipid levels. Clin Ther 2003;25 Suppl B:B64-80.

Boyle PJ, King AB, Olansky L, Marchetti A, Lau H, Magar R et al. Effects of pioglitazone and rosiglitazone on blood lipid levels and glycemic control in patients with type 2 diabetes mellitus: a retrospective review of randomly selected medical records. Clin Ther 2002;24:378-96.

Goldberg RB, Kandall DM, Deeg MA, Buse JB, Zagor AJ, Pinaire JA et al. A comparison of lipid and glycemic effects of pioglitazone and rosiglitazone in patients with type 2 diabetes mellitus and dyslipidemia. Diabetes Care 2005;28: 1547-54.

Mughal MA, Memon MY, Zardari MK, Tanwani RK, Ali M. Effect of acarbose on glycemic control, serum lipids and lipoproteins in type 2 diabetes. J Pak Med Assoc 2000;50:152-6.

Iwamoto Y, Kashiwagi A, Yamada N, Terao S, Mimori N, Suzuki M et al. Efficacy and safety of vildagliptin and voglibose in Japanese patients with type 2 diabetes; a 12 week, randomized, double blind, active controlled study. Diabetes Obes Metab 2010;12:700-8.

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Published

2017-02-04

How to Cite

Jindal, A., Gupta, M., Sharma, G., Mohan, G., & Tikoo, D. (2017). Comparative evaluation of voglibose versus pioglitazone on glycaemic control and lipid profile in patients of type 2 diabetes mellitus on glimepiride and metformin in punjabi population. International Journal of Basic & Clinical Pharmacology, 1(3), 160–167. Retrieved from https://www.ijbcp.com/index.php/ijbcp/article/view/1420

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