Impact of treatment with glibenclamide or vildagliptin on glucose variability after aerobic exercise in type 2 diabetes: A randomized controlled trial

Diabetes Res Clin Pract. 2018 Sep:143:184-193. doi: 10.1016/j.diabres.2018.07.007. Epub 2018 Jul 7.

Abstract

Aims: To evaluate the glucose variability, oxidative stress, metabolic and cardiovascular responses after an aerobic exercise session in diabetic patients on treatment with metformin plus vildagliptin or glibenclamide.

Methods: Parallel clinical trial including patients with type 2 diabetes treated with metformin plus vildagliptin or glibenclamide for 12 weeks. Glucose variability, oxidative stress, metabolic (plasma glucose, insulin and glucagon-like-peptide-1) and cardiovascular responses were evaluated at rest, during and after a 30 min aerobic exercise session (70% of the peak heart rate).

Results: Thirteen patients were included, seven in vildagliptin group (METV) and six in glibenclamide group (METG), baseline glycated hemoglobin (HbA1c) 8.8 ± 0.3%. Treatment reduced HbA1c (1.2% and 1.5% for METV and METG, respectively). The aerobic exercise session did not change glucose variability in both groups. A decrease in glucose during exercise recovery was found, with area under the curve lower in the METG vs. METV (p = 0.04). After the intervention, systolic blood pressure (SBP) decreased in both groups. Patients treated with vildagliptin showed lower SBP variability compared to those treated with glibenclamide.

Conclusions: Besides improvement in glucose control and reduction of SBP obtained by both treatments, lower blood pressure variability was observed in patients receiving vildagliptin. Glucose variability remained unaffected by both interventions and the exercise session.

Keywords: Diabetes mellitus; Dipeptidyl peptidase-IV inhibitors; Exercise; Glucose variability; Hypoglycemic agents; Sulphonylurea.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adamantane / analogs & derivatives*
  • Adamantane / therapeutic use
  • Aged
  • Diabetes Mellitus, Type 2 / blood
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use*
  • Exercise / physiology*
  • Female
  • Glucose / metabolism*
  • Glyburide / therapeutic use*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Nitriles / therapeutic use*
  • Pyrrolidines / therapeutic use*
  • Vildagliptin

Substances

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