Key result
Nateglinide significantly reduced carotid intima-media thickness compared to no treatment in drug-naive type 2 diabetic patients with HbA1c <6.5% (-0.017 vs 0.024 mm/year; P=0.0064).
Why the study?
Does nateglinide reduce carotid intima-media thickness in drug-naive type 2 diabetic patients with good glycemic control?
RCT (n=78)
Open-label
randomized
Does nateglinide reduce carotid intima-media thickness in drug-naive type 2 diabetic patients with good glycemic control?
Absolute Event Rate: -0.017% vs 0.024%
p-value: p=0.0064
In drug-naive type 2 diabetic patients with good baseline glycemic control, nateglinide significantly reduced carotid intima-media thickness over 12 months compared to no treatment.
Nateglinide may slow early carotid atherosclerosis in well-controlled drug-naive T2DM; extends glycemic therapy evidence to vascular surrogate outcomes.
OBJECTIVE: Postprandial hyperglycemia observed in type 2 diabetes mellitus is a risk factor for atherosclerosis. The aim of this study was to investigate the effect of strict glycemic control by nateglinide on common carotid far wall intima-media thickness in type 2 diabetic patients who were already under good glycemic control. METHODS AND RESULTS: We performed an open labeled randomized prospective trial on 78 drug-naive type 2 diabetic patients whose HbA1c was less than 6.5%. Thirty-eight patients were randomly assigned to receive nateglinide (270 mg/dL) and 40 to control group (no treatment). After 12 months, a significant reduction in HbA1c was observed in the nateglinide group, whereas a significant increase of HbA1c was observed in the untreated group. The carotid intima-media thickness at the end of 1-year follow-up was significantly reduced in the nateglinide group compared with the untreated group (-0.017+/-0.054 mm/year versus 0.024+/-0.066 mm/year, P=0.0064). Whereas nateglinide treatment also reduced triglyceride, highly-sensitive C-reactive protein, and E-selectin, multiple regression analysis identified HbA1c as the only significant independent determinant of the change in carotid intima-media thickness. CONCLUSION: In type 2 diabetic patients with good glycemic control, further strict glycemic control by nateglinide results in regression of carotid intima-media thickness.
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Mita et al. (2007) conducted an RCT in type 2 diabetes mellitus (n=78). nateglinide vs. no treatment was evaluated on change in carotid intima-media thickness (p=0.0064). Nateglinide significantly reduced carotid intima-media thickness compared to no treatment in drug-naive type 2 diabetic patients with HbA1c <6.5% (-0.017 vs 0.024 mm/year; P=0.0064).
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