Effects of Vildagliptin and Metformin on Blood Pressure and Heart Rate Responses to Small Intestinal Glucose in Type 2 Diabetes

Diabetes Care. 2017 May;40(5):702-705. doi: 10.2337/dc16-2391. Epub 2017 Mar 3.

Abstract

Objective: To evaluate effects of vildagliptin and metformin on blood pressure (BP) and heart rate (HR) responses to intraduodenal (ID) glucose in diet-controlled type 2 diabetes.

Research design and methods: Study A compared vildagliptin (50 mg) and placebo, given 60 min before a 120-min ID glucose infusion at 2 or 4 kcal/min (ID2 or ID4) in 16 patients. Study B compared metformin (850 mg) and placebo, given 30 min before ID2 over 120 min in 9 patients.

Results: Systolic (P = 0.002) and diastolic (P < 0.001) BP were lower and HR greater (P = 0.005) after vildagliptin compared with placebo, without interaction between vildagliptin and the glucose infusion rate. In contrast, HR was greater after metformin than placebo (P < 0.001), without any difference in systolic or diastolic BP.

Conclusions: Vildagliptin reduces BP and increases HR, whereas metformin increases HR without affecting BP during ID glucose infusion in type 2 diabetes. These distinct cardiovascular profiles during enteral nutrient exposure may have implications for postprandial hypotension.

MeSH terms

  • Adamantane / analogs & derivatives*
  • Adamantane / pharmacology
  • Aged
  • Blood Pressure / drug effects*
  • Diabetes Mellitus, Type 2 / diet therapy
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Dipeptidyl-Peptidase IV Inhibitors / pharmacology*
  • Female
  • Glucose / administration & dosage
  • Heart Rate / drug effects*
  • Humans
  • Hypoglycemic Agents / pharmacology*
  • Intestine, Small
  • Male
  • Metformin / pharmacology*
  • Nitriles / pharmacology*
  • Postprandial Period
  • Pyrrolidines / pharmacology*
  • Vildagliptin

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Hypoglycemic Agents
  • Nitriles
  • Pyrrolidines
  • Metformin
  • Vildagliptin
  • Glucose
  • Adamantane

Associated data

  • ANZCTR/ACTRN12608000433303
  • ANZCTR/ACTRN12613001158752