Effects Of Metformin And Glipizide Monotherapy Or Combination Therapy In Chinese Non-obese Individuals With Newly Diagnosed Type2Diabetes

To compare the effects of metformin and glipizide monotherapy or combination therapy on glucose and lipid metabolism、β-cell function and insulin sensitivity in Chinese newly diagnosed non-obese individuals with type2diabetes.Methods:Prospective, multicenter, open-label, randomized, parallel-controlled clinical study,245patients were randomized to receive glipizide、metformin or glipizide/metformin for24weeks. Insulin sensitivity was measured by ISIM and1/HOMA-IR; β-cell function adjusted by insulin sensitivity was assessed from DI at early-phase DI30and total DI120.Results:1.Glycemic control:Glipizide、metformin monotherapy or glipizide/metformin combination for24weeks had the similar glucose-lowering effect, remarkablely reduced HbAlc、the fasting plasma glucose(FPG) level and the2-hour postprandial glucose(PPG), P<0.001; At the end of24weeks, with HbA1c≤7.0%as the therapy goal, The proportion of metformin group is93.3%,84.4%in glipizide group, glipizide/metformin combaniation group is95%(P=0.049).2.Lipid profile:TGs were effectively decreased in all of the three groups (P=0.010; P=0.037; P=0.007),besides,metformin monotherapy and glipizide/metformin combination significantly reduced cholesterol and LDL cholesterol level. After subgroups analysised, the decrease of TGs (P=0.037) and LDL-c (P=0.034)happened in overweight subjects of metformin group, Glipizide monotherapy reduced TGs and increased HDL-C level significantly in overweight patients of metformin group.No change occurred in normal weight groups.3.Weight effect:Weight (P<0.005)and BMI level (P<0.01) were both lowered in Metformin monotherapy group and glipizide/metformin combination group,no effect in glipizide group. After subgroups analysised, Metformin monotherapy for24weeks,1.88kg lost in normal weight subjects,2.77kg lost in overweight subjects.4. Insulin sensitivity:After24weeks of monotherapy metformin,1/HOMA-IR and ISIM were both improved in overweight individuals, no evident change in normal weight group; while, no significantly improvement in two subgroups of glipizide.5.β-cell function:HOME-B、InsAUC30/GluAUC30、InsAUC120/GluAUC120(P<0.01) were improved in all of three groups; After adjusted insulin sensitivity, DI30、DI120were remarkablely improved in three groups(P<0.001).Conclusion:Metformin and glipizide monotherapy or combination therapy in Chinese newly diagnosed non-obese individuals with type2diabetes for24weeks, showed that,1) Metformin and glipizide had similar hypoglycemic effect;2)Metformin could significantly reduce body weight, however, glipizide had no effect.3)Metformin in overweight patients significantly decreased serum TGs and LDL-c levels, glipizide in overweight patients significantly reduced serum TGs and increased HDL-c level.4)Metformin in overweight subjects could significantly improve peripheral tissue insulin sensitivity.5) Metformin and glipizide significantly improved β-cell function in both normal weight and overweight patients.