Key result
Vildagliptin reduced systolic (P=0.002) and diastolic (P<0.001) blood pressure and increased heart rate (P=0.005), whereas metformin only increased heart rate (P<0.001) compared with placebo.
Why the study?
Does vildagliptin or metformin affect blood pressure and heart rate responses to intraduodenal glucose in patients with diet-controlled type 2 diabetes?
RCT (n=25)
Does vildagliptin or metformin affect blood pressure and heart rate responses to intraduodenal glucose in patients with diet-controlled type 2 diabetes?
Vildagliptin, but not metformin, reduces blood pressure during enteral nutrient exposure in type 2 diabetes, which may have implications for managing postprandial hypotension.
Answers are grounded in this paper and cite their sources.
Vildagliptin may attenuate postprandial BP falls in T2D; hypothesis-generating for DPP-4 inhibitors in postprandial hypotension.
OBJECTIVE To evaluate effects of vildagliptin and metformin on blood pressure (BP) and heart rate (HR) responses to intraduodenal (ID) glucose in diet-controlled type 2 diabetes. RESEARCH DESIGN AND METHODS Study A compared vildagliptin (50 mg) and placebo, given 60 min before a 120-min ID glucose infusion at 2 or 4 kcal/min (ID2 or ID4) in 16 patients. Study B compared metformin (850 mg) and placebo, given 30 min before ID2 over 120 min in 9 patients. RESULTS Systolic (P = 0.002) and diastolic (P < 0.001) BP were lower and HR greater (P = 0.005) after vildagliptin compared with placebo, without interaction between vildagliptin and the glucose infusion rate. In contrast, HR was greater after metformin than placebo (P < 0.001), without any difference in systolic or diastolic BP. CONCLUSIONS Vildagliptin reduces BP and increases HR, whereas metformin increases HR without affecting BP during ID glucose infusion in type 2 diabetes. These distinct cardiovascular profiles during enteral nutrient exposure may have implications for postprandial hypotension.
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Wu et al. (2017) conducted an RCT in Diet-controlled type 2 diabetes (n=25). Vildagliptin and Metformin vs. Placebo was evaluated on Blood pressure and heart rate responses to intraduodenal glucose. Vildagliptin reduced systolic (P=0.002) and diastolic (P<0.001) blood pressure and increased heart rate (P=0.005), whereas metformin only increased heart rate (P<0.001) compared with placebo.
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