Effects of Metformin and Pioglitazone on Serum Pentosidine Levels in Type 2 Diabetes Mellitus

Objective: Accumulation of advanced glycation end products (AGEs) is associated with age- and diabetes-related disease. The aim of the present study is to investigate the effects of metformin or pioglitazone on serum pentosidine levels, a well-defined AGE, in type 2 diabetes.

Research Design And Methods: 66 Japanese patients were enrolled in this 6 months open-label study. In the metformin (n=22), the pioglitazone (n=22), and the control (optimal diet therapy, sulfonylurea and/or insulin) groups (n=22), serum levels of HbA (1c) and pentosidine were measured at baseline and 6 months after each treatment.

Results: HbA (1c) and pentosidine levels were not different at baseline among 3 groups, and HbA(1c) was significantly decreased at 6 months in each group. In the metformin and the pioglitazone groups, serum pentosidine levels were significantly decreased at 6 months after treatments (p=0.039 and p=0.031, respectively). Percent changes in pentosidine levels in the metformin and the pioglitazone groups were significantly lower than that in the control group (p=0.012 and p=0.019, respectively).

Conclusion: 6 months treatments with metformin or pioglitazone in clinical doses decreased serum pentosidine levels which resulted in greater %change of serum pentosidine levels than the control group, suggesting that these agents may prevent the diabetic complications associated with AGEs accumulation.