Objective: To evaluate the action of vildagliptin + metformin on some adipocytokine levels, glycemic control, and β-cell function in type 2 diabetic patients.
Research design and methods: A total of 171 patients with poor glycemic control were instructed to add after a 8 ± 2 month-run-in period with metformin, vildagliptin 50 mg twice a day or placebo for 12 months.
Main outcome measures: We evaluated at 3, 6, 9, and 12 months, the body mass index (BMI), glycemic control, fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), homeostasis model assessment β-cell function index (HOMA-β), fasting plasma proinsulin (FPr), proinsulin/fasting plasma insulin ratio (Pr/FPI ratio), C-peptide, glucagon, resistin, retinol-binding protein-4 (RBP-4), chemerin, and tumor necrosis factor-α (TNF-α). Patients also underwent a combined euglycemic hyperinsulinemic and hyperglycemic clamp, with subsequent arginine stimulation to assess insulin sensitivity and insulin secretion.
Results: After 12 months of vildagliptin + metformin, we observed a better decrease of body weight, glycemic control, HOMA-IR, and glucagon, and a better increase of HOMA-β, and of all the measures of β-cell function, compared to placebo + metformin. Vildagliptin + metformin also decreased resistin, RBP-4, and chemerin better.
Conclusion: Vildagliptin seems to have a positive action on some adipocytokines related to inflammation.