Glimepiride may slow atherosclerosis progression in Type 2 diabetes
MedWire News: Treatment with glimepiride slows progression of carotid intima-media thickness (IMT) to a greater degree than glibenclamide in patients with Type 2 diabetes, suggest results from a small observational study.
"Recent studies reported that glimepiride increased plasma adiponectin levels and decreased plasma tumor necrosis factor-α levels in Type 2 diabetics," the say researchers.
In addition, "in animal models, glimepiride has been shown to reduce atherosclerotic lesions as compared to conventional sulfonylureas [eg, glibenclamide]."
Naoto Katakami (Osaka University, Japan) and colleagues therefore followed-up 40 Type 2 diabetes patients, aged 65.2 years on average - 20 treated with glimepiride and 20 with glibenclamide - for 3 years to assess the potential impact on subclinical progression of atherosclerosis, as measured by carotid IMT.
They found that patients treated with glimepiride had a significantly slower progression of carotid IMT over the study period than those treated with glibenclamide, at -0.044 versus +0.077 mm/year.
The researchers say that these results agree with those of a previous clinical trial that showed a significant improvement of brachial-ankle pulse wave velocity and augmentation index in patients treated with glimepiride who had switched from glibenclamide.
"Since glimepiride has been shown to improve insulin sensitivity and modulate plasma adipocytokine levels in diabetic patients, these actions may explain the mechanisms of its beneficial effect on the progression of carotid IMT," say Katakami et al.
They conclude: "We consider this study not conclusive but hypothesis generating. Larger replication studies should be designed with appropriate sample size calculations and our results could provide a rationale to conduct such studies."
The results of this study are published in the journal Diabetes Research and Clinical Practice.
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By Helen Albert