Pioglitazone Metabolic Effect in Metformin-Intolerant Obese Patients Treated with Sibutramine
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概要
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Objective Metformin is the drug of choice to treat obese type 2 diabetes patients because it reduces either insulin-resistance and body weight. We aimed to comparatively test the efficacy and tolerability of pioglitazone and sibutramine in metformin-intolerant obese type 2 diabetic patients treated with sibutramine. Materials and Methods Five hundred and seventy-six consecutive Caucasian obese type 2 diabetic patients were evaluated during a 12-months period and fifty-two patients were resulted intolerant to metformin at maximum dosage (3,000 mg/day). All intolerant patients to metformin received a treatment with pioglitazone (45 mg/day) and sibutramine (10 mg/day) and they were compared with fifty-three patients treated with metformin (3,000 mg/day) and sibutramine (10 mg/day) for 6 months in a single-blind controlled trial. We assessed body mass index, waist circumference, glycated hemoglobin, Fasting Plasma glucose, postprandial plasma glucose, fasting plasma insulin, postprandial plasma insulin, lipid profile, systolic blood pressure, diastolic blood pressure and heart rate at baseline and after 3, and 6 months. Results No body mass index change was observed at 3, and 6 months in pioglitazone + sibutramine group, while a significant reduction of body mass index and waist circumference was observed after 6 months in metformin + sibutramine group (p<0.05). A significant decrease of glycated hemoglobin, Fasting Plasma glucose, postprandial plasma glucose, fasting plasma insulin, postprandial plasma insulin and HOMA index was observed after 3, and 6 months in both groups (p<0.05, and p<0.01, respectively). A significant Tg reduction was present after 6 months (p<0.05) in both groups respect to the baseline values. No systolic blood pressure, diastolic blood pressure and heart rate change was obtained after 3, and 6 months in both groups. Conclusion Pioglitazone and sibutramine combination appears to be a short-term equally efficacious and well-tolerated therapeutic alternative respect to metformin-intolerant obese type 2 diabetic patients treated with sibutramine.
著者
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DEROSA Giuseppe
Department of Internal Medicine and Therapeutics, University of Pavia
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MAFFIOLI Pamela
Department of Internal Medicine and Therapeutics, University of Pavia
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AT SALVADEO
Department of Internal Medicine and Therapeutics, University of Pavia
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FERRARI Ilaria
Department of Internal Medicine and Therapeutics, University of Pavia
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GRAVINA Alessia
Department of Internal Medicine and Therapeutics, University of Pavia
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MEREU Roberto
Department of Internal Medicine and Therapeutics, University of Pavia
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Ferrari Ilaria
Department Of Internal Medicine And Therapeutics University Of Pavia
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DAngelo Angela
Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico
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Ciccarelli Leonardina
RSA Don Leone Porta
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N. Piccinni
Fondazione Ospedale della Carità
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FG Cicero
Atherosclerosis Study Center "G. Descovich", Clinical Medicine and Applied Biotechnology Department
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Mereu Roberto
Department Of Internal Medicine And Therapeutics University Of Pavia
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Gravina Alessia
Department Of Internal Medicine And Therapeutics University Of Pavia
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Derosa Giuseppe
Department Of Internal Medicine And Therapeutics Centro Ipertensione E Fisiopatologia Cardiovascolar
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Maffioli Pamela
Department Of Internal Medicine And Therapeutics Centro Ipertensione E Fisiopatologia Cardiovascolare University Of Pavia
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FG Cicero
Atherosclerosis Study Center "G. Descovich", Clinical Medicine and Applied Biotechnology Department "D. Campanacci", University of Bologna
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Ferrari Ilaria
Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo
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Derosa Giuseppe
Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo
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Maffioli Pamela
Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo
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Gravina Alessia
Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo
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