Objective        To compare the effect of mitiglinide and repaglinide on glycometabolism

cardiovascular risk factors and oxidative stress in patients with newly diagnosed type 2 diabetes mellitus (T2DM).       Methods       Ninety newly diagnosed T2DM patients were randomly assigned to group A and

group B. The patients of group A received repaglinide plus metformin treatment

while those of group B were given mitiglinide plus metformin treatment. Continuous glucose monitoring system (CGMS) was used to record the dynamic changes and fluctuation of blood glucose in all patients during the first 3 days. All the patients were followed up to examine the corresponding indices after 12 weeks.       Results       After treatment for 3 days

the fasting blood glucose (FBG)

mean blood glucose (MBG) at 30 min

and 1

2 and 3 h after meals

and 24 h MBG decreased in both groups. The decrease of 1 h MBG and 2 h MBG was more significant in group B than in group A (P0.05)

while the mean amplitude of glycemic excursion (MAGE) was significantly lower in group B than in group A (P0.05). Twelve weeks later

FBG and postprandial blood glucose (1 h PBG and 2 h PBG) significantly decreased in both groups (P0.05)

and the decrease in group B was more significant than that in group A (P0.05). Fasting insulin (FINS) and postprandial insulin (1 h INS and 2 h INS) increased in both groups

and the increase of 1 h INS and 2 h INS was more significant in group B than in group A (P0.05). Glycosylated hemoglobin-A

1c

(HbA

1c

) in both groups decreased (P0.05)

and the decrease was more significant in group B than in group A.  Both groups could significantly decrease the level of HOMA insulin resistance (HOMA-IR) and increase the level of insulin sensitive index (ISI) (P0.05)

and the effect was more significant in group B than in group A (P0.05). The proportion of hypoglycemia in group B was lower than that in group A. Both groups could partly decrease the levels of total cholesterol (TC)

triglycerides (TG) and fibrinogen (FG)

and increase the level of high-density lipoprotein cholesterol (HDL-c). However

they had no significant effect on plasminogen activator inhibitor-1 (PAI-1) (P0.05). Both groups could decrease the level of superoxide dismutase (SOD) and increase the level of malondialdehyde (MDA)

and the ef

fect was more significant in group B than in group A (P0.05).       Conclusion       For newly diagnosed T2DM

both mitiglinide and repaglinide can decrease FBG and PBG significantly in a short term

but mitiglinide can keep MAGE more steadily. After a long period of therapy

mitiglinide can significantly decrease the levels of cardiovascular risk factors and suppress antioxidative stress with lower incidence of hypoglycemia as compared with repaglinide.