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Schiappacassa A, Maranhão PA, Souza MDGC, et al. Acute Effects of Metformin and Vildagliptin after a Lipid-Rich Meal on Postprandial Microvascular Reactivity in Patients with Type 2 Diabetes and Obesity: A Randomized Trial. J Clin Med. 2020;9(10)doi: 10.3390/jcm9103228.
Schiappacassa, A., Maranhão, P. A., Souza, M. D. G. C., Panazzolo, D. G., Nogueira Neto, J. F., Bouskela, E., & Kraemer-Aguiar, L. G. (2020). Acute Effects of Metformin and Vildagliptin after a Lipid-Rich Meal on Postprandial Microvascular Reactivity in Patients with Type 2 Diabetes and Obesity: A Randomized Trial. Journal of clinical medicine, 9(10), . https://doi.org/10.3390/jcm9103228
Schiappacassa, Alessandra, et al. "Acute Effects of Metformin and Vildagliptin after a Lipid-Rich Meal on Postprandial Microvascular Reactivity in Patients with Type 2 Diabetes and Obesity: A Randomized Trial." Journal of clinical medicine vol. 9,10 (2020). doi: https://doi.org/10.3390/jcm9103228
Schiappacassa A, Maranhão PA, Souza MDGC, Panazzolo DG, Nogueira Neto JF, Bouskela E, Kraemer-Aguiar LG. Acute Effects of Metformin and Vildagliptin after a Lipid-Rich Meal on Postprandial Microvascular Reactivity in Patients with Type 2 Diabetes and Obesity: A Randomized Trial. J Clin Med. 2020 Oct 09;9(10). doi: 10.3390/jcm9103228. PMID: 33050169; PMCID: PMC7601890.
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J Clin Med. 2020 Oct 09;9(10). doi: 10.3390/jcm9103228.

Acute Effects of Metformin and Vildagliptin after a Lipid-Rich Meal on Postprandial Microvascular Reactivity in Patients with Type 2 Diabetes and Obesity: A Randomized Trial.

Journal of clinical medicine

Alessandra Schiappacassa, Priscila A Maranhão, Maria das Graças Coelho de Souza, Diogo G Panazzolo, José Firmino Nogueira Neto, Eliete Bouskela, Luiz Guilherme Kraemer-Aguiar

Affiliations

  1. Post-Graduate Program in Clinical and Experimental Physiopathology (FISCLINEX), Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-013, Brazil.
  2. Laboratory of Clinical and Experimental Research on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-013, Brazil.
  3. Lipids Laboratory (Lablip), Policlínica Piquet Carneiro, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-003, Brazil.
  4. Obesity Unit, Policlínica Piquet Carneiro, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-030, Brazil.

PMID: 33050169 PMCID: PMC7601890 DOI: 10.3390/jcm9103228

Abstract

BACKGROUND: Type 2 diabetes mellitus and obesity are both related to endothelial dysfunction. Postprandial lipemia is a cardiovascular risk. Notably, it is known that a high-fat diet may elicit microvascular dysfunction, even in healthy subjects. Since anti-diabetic drugs have different mechanisms of action and also distinct vascular benefits, we aimed to compare the results of two anti-diabetic drugs after the intake of a lipid-rich meal on microcirculation in patients with type 2 diabetes and obesity. In parallel, we also investigated the metabolic profile, oxidative stress, inflammation, plasma viscosity, and some gastrointestinal peptides.

SUBJECTS/METHODS: We included 38 drug-naïve patients, all women aged between 19 and 50 years, with BMI ≥ 30 kg/m

RESULTS: No differences at baseline were noted between groups. Vildagliptin increased glucagon-like peptide-1 compared to metformin. Paired comparisons showed that, during the postprandial period, vildagliptin significantly changed levels of insulin and glucagon-like peptide-1, and also the dipeptidyl peptidase-4 activity, while metformin had effects on plasma glucose solely. Metformin use during the test meal promoted an increase in functional capillary density, while vildagliptin kept non-nutritive microvascular blood flow and vasomotion unchanged.

CONCLUSIONS: After the intake of a lipid-rich meal, the use of vildagliptin preserved postprandial non-nutritive microflow and vasomotion, while metformin increased capillary recruitment, suggesting protective and different mechanisms of action on microcirculation.

Keywords: diabetes; metformin; microcirculation; postprandial; vildagliptin

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