Diabetes Mellitus Clinical Trial
Official title:
Phase 4 Study Evaluation of the Effects of Acarbose Versus Glibenclamide on Mean Amplitude of Glycemic Excursions and Oxidative Stress in Patients With Type 2 Diabetes Insufficiently Controlled by Metformin
To compare effect of acarbose versus glibenclamide treatment on mean amplitude of glyclemic excursion and oxidative stress in diabetes individuals who failed to control their glucose by metformin therapy alone
This is a randomised and open-label study conducted in 2 medical centers in central part of
Taiwan. Type 2 diabetic outpatients were eligible if they were aged 30-70 years, were on
mono- or dual oral antidiabetic drugs for at least 3 months, and had a glycated hemoglobin
(HbA1c) value between 7.0% and 11.0%. Patients who were treated with insulin or drugs that
promote weight loss, had impaired renal (serum creatinine concentration greater than 132.6
μmol/l) or liver (AST or ALT 2.5 times upper limit of normal range) function, had a history
of hemoglobinopathy or chronic anemia, or women of child-bearing potential without adequate
contraception were excluded. All patients provided their informed consent before they were
enrolled in this study.
After an 8-week period of metformin monotherapy (500 mg t.i.d.), all patients were
randomised to add on either acarbose or glibenclamide. The doses of acarbose and
glibenclamide were 50 mg t.i.d. and 2.5 mg t.i.d., respectively, for 4 weeks and
force-titrated to 100 mg t.i.d. and 5 mg t.i.d., respectively, for the last 12 weeks. A
complete 72 hours of glucose monitoring using a continuous glucose monitoring (CGM) system
and meal tolerance test (MTT) after a 10-h overnight fasting were performed before
randomisation and in the end of study. Morning urine samples were collected for measurement
of 8-iso prostaglandin F2α (8-iso PGF2α), a commonly used parameter of oxidative stress
(13-14). The primary objectives are the changes of MAGE obtained from CGM and urinary
excretion rate of 8-iso PGF2α. The secondary objectives include changes of HbA1c, lipid
profiles including total cholesterol, low-density lipoprotein cholesterol (LDL-C),
high-density lipoprotein cholesterol (HDL-C), and triglycerides, oxidized low-density
lipoprotein (ox-LDL), high-sensitivity C-reactive protein (hs-CRP), total adiponectin, and
high-molecular weight (HMW) adiponectin.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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