Effects of Pioglitazone,Repaglinide or Metformin on Blood Uric Acid and Renal Function in Recent-onset Type 2 Diabetes

OBJECTIVE To compare the effects of pioglitazone,metformin and repaglinide on blood glucose,serum uric acid and renal function in recent-onset type 2 diabetes.METHODS Seventy-five recent-onset type 2 diabetes with hyperuricemia analyzed.Fasting glucose,2-hour glucose,glycation hemoglobin(HbA1c),serum uric acid,microalbuminuria(MAwere U),blood urea nitrogen(BUN),serum creatinine(Cr),total cholesterol(TC) and triglyceride(TG) were measured before and after 12 weeks of treatment with pioglitazone(n=25),repaglinide(n=25) or metformin(n=25).RESULTS Fasting glucose,2-hour glucose,HbA1c,serum uric acid,MAU,BUN,Cr,TC and TG decreased significantly at 12 weeks in patients receiving pioglitazone(P0.05).Fasting glucose,2-hour glucose and HbA1c decreased significantly at 12 weeks in patients receiving repaglinide(P0.05).Fasting glucose,2-hour glucose,HbA1c,MAU,TC and TG decreased significantly at 12 weeks in patients receiving metformin(P0.05).At 12 weeks,the repaglinide group had lower fasting glucose,2-hour glucose and HbA1c,than the pioglitazone group and the metformin group(P0.05).The pioglitazone group had lower serum uric acid,BUN and Cr,than the repaglinide group and the metformin group(P0.05).The pioglitazone group had lower MAU than the metformin group(P0.05).CONCLUSION Repaglinide lead to a decrease on blood glucose decrease;pioglitazone lead to a decrease on serum uric acid,and improved renal function.For recent-onset type 2 diabetes who also have diabetic nephropathy,hyperuricemia or gout,pioglitazone is a better choice.