Comparison of Metformin and Pioglitazone Effects on Adipokines Concentrations in Newly Diagnosed Type 2 Diabetes Patients

• Serum concentrations of omentin [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  Serum concentrations of adipose tissue derived cytokine omentin
• Serum concentrations of leptin [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  Serum concentrations of adipose tissue derived cytokine leptin

Oral hypoglycemic agents encompass the mainstay of treatment in the majority of patients with type 2 diabetes. Thiazolidinediones (such a pioglitazone) and Biguanides (such as metformin), are two major groups of hypoglycemic medications that while function via different pathways, are both effective in short- and long-term glycemic control . These medications diminish or at least delay long term micro- and macrovascular complications associated with prolonged insulin resistance although at different rates. The mechanisms by which this aim is achieved, nevertheless, remains largely unclear. With adipokines playing a key role in development of both insulin resistance and atherosclerosis, oral hypoglycemic agents might regulate these substances by direct and indirect routes.

• Drug: Metformin
  Metformin 1000 mg fixed dose, twice daily (500 mg tablets x 2)
• Drug: Pioglitazone
  Pioglitazone 30 mg fixed dose, twice daily (15 mg tablets x 2)

• Active Comparator: Metformin
  patients receiving fixed dose metformin 1000 mg daily
  Intervention: Drug: Metformin
• Active Comparator: Pioglitazone
  patients receiving fixed dose pioglitazone 30 mg daily
  Intervention: Drug: Pioglitazone

Inclusion Criteria:

• Newly diagnosed type 2 diabetes patients based on American Diabetes Association criteria (2011) for diagnosis of diabetes

Exclusion Criteria:

• previous intake of oral hypoglycemic agents for treatment of diabetes or other hyperglycemia associated conditions
• intake of glucocorticoids in the past one year
• major illnesses of heart, lung, kidney, and liver.