In a nutshell
This study compared the effectiveness of chiglitazar (Bilessglu) and sitagliptin (Januvia) on glycemic (blood glucose) variations, insulin resistance, and inflammation levels in patients with type 2 diabetes (T2D). The data showed that chiglitazar treatment was more effective at improving insulin resistance and inflammation compared with sitagliptin in these patients.
T2D is a chronic disease that is associated with insulin resistance (unresponsive muscle, fat, and liver cells to the effects of insulin, the hormone that helps glucose enter cells). Risk factors for insulin resistance include unhealthy diets, inactive lifestyles, and inflammation. Preventing blood glucose variations (glycemic variations) is important in reducing complications in patients with T2D.
Sitagliptin is an anti-diabetic medication used in the treatment of T2D. It acts on gut hormones and helps release more insulin from the pancreas. Chiglitazar is a new non-thiazolidinedione (TZD) drug that affects the expression of genes related to glucose control and fat regulation. Small studies on chiglitazar have shown its safety and effectiveness in older patients with T2D. However, the effect of chiglitazar on blood glucose variations, insulin resistance, and inflammation in patients with T2D remains unclear.
Methods & findings
This study included 81 patients with T2D. Patients had poorly controlled blood glucose despite a strict diet and exercise therapy. 54 patients were randomly assigned to receive chiglitazar (group1). 27 patients were randomly placed to receive sitagliptin treatment (group 2). Patients were treated for 24 weeks.
Continuous glucose monitoring was done in patients for 72 hours. Serum levels of hemoglobin A1c (average blood glucose over 2-3 months; HbA1c), fasting blood glucose (FBG), 2-hour postprandial (after meal) blood glucose (2-h PBG), fasting insulin (Fins) and blood indicators of inflammation were measured.
The average HbA1c level in patients was 8.29%. Reductions in HbA1c levels were similar for chiglitazar (by 1.37%) and sitagliptin (by 1.35%). Chiglitazar treatment resulted in significantly reduced glucose variations, improved insulin resistance, and decreased levels of blood inflammatory markers.
There were no significant episodes of hypoglycemia (dangerously low blood glucose levels) or significant side effects in both groups.
The bottom line
The study showed similar improvements in HbA1c and average blood glucose levels for chiglitazar and sitagliptin over 24 weeks. Also, chiglitazar showed better improvement in insulin resistance and blood inflammation compared to sitagliptin in patients with T2D.
The fine print
The sample size of the study was small and the follow-up period was short. Larger studies are needed to validate the results.
Published By :
Diabetes Research and Clinical Practice
Dec 01, 2021
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