Metformin Outperforms Vildagliptin in Reducing BMI and Weight in T2D Patients: Study
Researchers have found that both vildagliptin and metformin reduce hepatic steatosis effectively and improve glycemic control in newly diagnosed type 2 diabetes mellitus (T2D) patients. A recent study was conducted by Asmaa and colleagues which was published in the journal BMC Pharmacology and Toxicology.
Hepatic steatosis (HS), one of the most common complications of T2D, is largely associated with adiposity and glycemic dysregulation. This study was done to compare the effect of vildagliptin and metformin on hepatic steatosis through the use of HSI and ultrasound grading, as well as their consequences on metabolic parameters.
This study enrolled newly diagnosed T2D patients with a total of 246 for this randomized controlled trial. Patients were randomly allocated to the following groups:
• Group 1: 117 patients received 50 mg of vildagliptin orally twice daily.
• Group 2: 129 patients received 500 mg of metformin orally twice daily, with doses titrated weekly by 500 mg to a maximum of 2000 mg per day.
Assessment Parameters: baseline and 6 months followed by fasting blood glucose (FBG), HbA1c, and physical measurements: weight; BMI; waist circumference (WC); hip circumference (HC); HSI and grading of hepatic steatosis via ultrasound.
Key findings
• 246 newly diagnosed T2D patients participated: 117 in the vildagliptin group, 129 in the metformin group.
• Both groups showed significant improvement in FBG, HbA1c, weight, BMI, WC, HC, HSI, and hepatic steatosis grading baseline to 6 months (p < 0.001).
• Compared with Vildagliptin, metformin proved efficacious to a greater extent in both weight reduction and BMI (p = 0.001 and p = 0.009, respectively).
• There was a strong correlation of HSI with HbA1c, BMI, WC, HC (p < 0.001), and FBG (p = 0.008).
• Lipid profile (total cholesterol and LDL) was the best predictor of hepatic steatosis.
Both vildagliptin and metformin were effective in terms of improving glycaemic control and lowering the degree of hepatic steatosis in newly diagnosed T2D patients. Metformin had a better effect on weight and attained a lower BMI; thus, it is likely to benefit patients who have obesity-related complications even more so than vildagliptin.
Reference:
Mohamed, A. S., Ahmad, H. M., Sharawy, M. A., & Kamel, F. M. M. (2024). The effect of vildagliptin versus metformin on hepatic steatosis in type 2 diabetic patients: a randomized controlled trial. BMC Pharmacology and Toxicology, 25(1). https://doi.org/10.1186/s40360-024-00818-7
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