School of Medicine Publications and Presentations

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To test potential differences between the actions of anti-diabetic medications, we examined the effects of oral hypoglycemic agents versus insulin glargine-apidra therapy in T2DM.


T2DM subjects were randomized to either OHA (pioglitazone, metformin, glipizide, n=9) or IT (n=12) for 6 months. Carotid intimal media thickness (CIMT), vascular reactivity [FMD] (% change in brachial arterial diameter [BD] post-ischemia), and sublingual nitrate [SLN] were measured with ultrasonography. Euglycemic hyperinsulinemic (80 mU/m2) clamp with [3]-3H-glucose and muscle biopsies were performed.


FPG (∼257 to ∼124, OHA ∼256 to ∼142 mg/dl, IT) and HgbA1C (∼10.3 to ∼6.4%, OHA; ∼10.7 to ∼7.1%, IT), improved comparably. EGP (∼2.1 to ∼1.7, OHA; ∼2.3 to ∼2.0, IT) and EGP suppression by insulin (∼0.4 to ∼0.3, OHA; ∼0.5 to ∼0.7 mg/kg.min, IT) was different. Total glucose disposal [TGD/I) × 100] increased in OHA (∼5.2 to ∼8.1, p=0.03), but not in IT (∼6.0 to ∼5.4 mg/kg.min/μU/ml × 100). OHA reduced CIMT (∼0.080 to ∼0.068, p<0.05), whereas IT did not (∼0.075 to ∼0.072 cm). After SLN, BD increased in OHA (∼8.7 to ∼18.2%), but not in IT (∼11.2 to ∼15.0), [p<0.02]. Except for plasma adiponectin (∼7 to ∼15, OHA vs. ∼6 to ∼10, IT), changes in inflammatory markers in the circulation and in muscle (IκBα, SOD2 & MCP1, p-ERK and JNK) were equivalent.


OHA and IT achieved adequate glycemic control and the effects on circulating and muscle inflammatory biomarkers were similar, but only OHA improved insulin sensitivity, vascular function and CIMT. These findings in a small sample suggest that the use of OHA provide additional benefits to patients with T2DM.

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Diabetes/metabolism research and reviews



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Mentor/PI Department

Office of Human Genetics



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