The Effect of Sitagliptin on Hypertension, Arterial Stiffness, Oxidative Stress and Inflammation
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Purpose
Recently a new category of antihyperglycemic therapy aiming to modulate the incretin system has emerged. These drugs induce insulin secretion without inducing hypoglycemia. The effect of the incretin modulators drugs on hypertension, arterial stiffness, inflammation and oxidative stress parameters have not been fully investigated yet.GLP-1 analogue has been suggested to have an effect on endothelium and the development of hypertension. Nystrom et al have demonstrated that GLP-1 improves endothelial dysfunction in a small group of type 2 diabetes subjects, with coronary heart disease. We hypothesize that DPP-4 inhibitor will have an effect on hypertension and arterial stiffness by effect on the NO pathway.The aim of this study is to investigate the effect of two insulin inducers drugs, sulfonyl urea and DPP-4 inhibitor on 24 hours blood pressure monitoring, arterial stiffness, oxidative stress and inflammation.
| Condition | Intervention |
|---|---|
|
Diabetes Mellitus Arterial Stiffness |
Drug: sitagliptin Drug: glibenclamide |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Crossover Assignment Masking: Open Label |
| Official Title: | The Effect of Sitagliptin on Hypertension, Arterial Stiffness, Oxidative Stress and Inflammation |
- arterial stiffness, defined as change in augmentation index measured by means of a non-invasive technique using the commercially available SphygmoCor System, and the results of the 24 hour blood pressure monitoring [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- The secondary end results would be oxidative stress parameters, as evaluated by oxidized LDL and Isoprostanes, and markers of inflammatory status, including measurements of pro-inflammatory interleukins and performance of highly sensitive CRP test. [ Time Frame: 6 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 60 |
| Study Start Date: | June 2008 |
| Estimated Study Completion Date: | June 2009 |
| Estimated Primary Completion Date: | June 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: A
diabetic patients who are treated with metformin wiyh HBA1C>7% will get sitagliptin
|
Drug: sitagliptin
sitagliptin 100 mg once daily for 3 months
Other Name: sitagliptin
|
|
Experimental: B
diabetic patients who are treated with metformin with HBA1C>7% will get glibenclamide
|
Drug: glibenclamide
glibenclamide 5 mg once a day titrated as neede up to 20 mg a day
Other Name: glibenclamide
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- diabetic patients
- aged 18 years or older
- treated with metformin
- Only patients with HbA1C levels within the range 7% - 11% will be enrolled in the study
Exclusion Criteria:
- CCT<30
- A history of treatment with incretins or sulfonylurea during the last 3 months
- Treatment with nitrates
- Uncontrolled heart failure
- Uncontrolled hypertension and/or any change in the hypertensive medications within one month prior starting the study
- No proven regular treatment with aspirin or statins within one month prior starting the study
- Any malignancy with life expectancy of less then 1 year
- pregnancy
Contacts and Locations| Contact: Shlomit Koren, MD | 972-546-888-385 | shlomitks@gmail.com |
| Contact: Shai Efrati, MD | 972-577-346-364 | efratishai@013.net |
| Israel | |
| Department of Internal Medicine A , Research & Development unit Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler School of Medicine, Tel Aviv, Israel | Recruiting |
| Zrifin, Israel, 70300 | |
| Contact: Shlomit Koren, MD 972-546-888=385 shlomitks@gmail.com | |
| Contact: Shai Efrati, MD 972-577-346-364 efratishai@013.net | |
| Principal Investigator: Shlomit Koren, MD | |
| Principal Investigator: | Shlomit Koren, MD | Department of Internal Medicine A , Research & Development unit Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler School of Medicine, Tel Aviv, Israel |
More Information
No publications provided
| Responsible Party: | Shlomit Koren MD, Assaf-Harofeh Medical Center internal medicine A |
| ClinicalTrials.gov Identifier: | NCT00696982 History of Changes |
| Other Study ID Numbers: | shlomit9 |
| Study First Received: | June 11, 2008 |
| Last Updated: | June 12, 2008 |
| Health Authority: | Israel: Israeli Health Ministry Pharmaceutical Administration |
Keywords provided by Assaf-Harofeh Medical Center:
|
Arterial stiffness Augmentation index diabetes mellitus |
Additional relevant MeSH terms:
|
Diabetes Mellitus Hypertension Inflammation Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Vascular Diseases Cardiovascular Diseases Pathologic Processes |
Sitagliptin Glyburide Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions Dipeptidyl-Peptidase IV Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on June 18, 2013