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Colestilan beneficial in glycemic control and LDL cholesterol
Results from a new clinical trial show that bile acid sequestrant colestilan improves glycated hemoglobin (HbA1c) and reduces low-density lipoprotein (LDL) cholesterol in Type 2 diabetics.
In this study, the team comprising of Kazuoki Kondo (Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan) and his co-workers recruited 183 patients with Type 2 diabetes with a fasting plasma glucose of 7.2–11.1 mmol/l and an HbA1c of 7.0% or more. They were then randomly assigned to receive either 4500 mg/day colestilan (3 tablets of 500 mg at a time, 3 times/day or placebo for 12 weeks.
The results show that at the 12th week colestilan had significantly reduced both HbA1c and fasting plasma glucose by 0.9% and 1.2 mmol/l, respectively, but no significant reductions in fasting insulin were observed.A significant 22.5% reduction in LDL cholesterol was also achieved by the treatment group versus placebo at 12 weeks.
“Colestilan when given alone alleviates markers of hyperglycemia and dyslipidemia in patients with Type 2 diabetes,” summarize the authors.
Frequently observed adverse events of the drug were constipation, nasopharyngitis, andeczema
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Overall Mortality in Patients With Type 2 Diabetes May Be Similar With Different Sulfonylureas
The March 9 issue of Diabetes Care has study results concluding that the risk for overall mortality is similar in patients with type 2 diabetes receiving glipizide, glyburide, or glimepiride monotherapy. However, the findings suggest that glimepiride may be the preferred sulfonylurea in patients with underlying coronary artery disease (CAD).
The study was conducted mainly to assess the link between individual sulfonyl ureas, which are historically used as a medication class in type 2 diabetes and the risk of overall mortality in a large cohort of patients with type 2 diabetes.
In the entire cohort, the agents including glyburide, glipizide, and glimepiride did not differ significantly in the risk for overall mortality. In patients with documented CAD, however, there was a trend towards increased overall mortality risk with glyburide vs glimepiride (hazard ratio [HR], 1.36; 95% confidence interval [CI], 0.96 - 1.91) and glipizide vs glimepiride (HR, 1.39; 95% CI, 0.99 - 1.96).
On the basis of these findings, the investigators concluded that no increased mortality risk among the individual sulfonylureas was identified. However, they did suggest that glimepiride may be the preferred sulfonylurea in patients with underlying CAD.
Diabetes Care. Published online March 9, 2010. Abstract
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