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document
Nateglinide reduces carotid intima-media thickening in type 2 diabetic patients under good glycemic control . OBJECTIVE Postprandial hyperglycemia observed in type 2 diabetes mellitus is a risk factor for atherosclerosis . The aim of this study was to investigate the effect of strict glycemic control by nateglinide on common carotid far wall intima-media thickness in type 2 diabetic patients who were already under good glycemic control . METHODS AND RESULTS We performed an open labeled randomized prospective trial on 78 drug-naive type 2 diabetic patients whose HbA1c was less than 6.5 % . Thirty-eight patients were randomly assigned to receive nateglinide ( 270 mg/dL ) and 40 to control group ( no treatment ) . After 12 months , a significant reduction in HbA1c was observed in the nateglinide group , whereas a significant increase of HbA1c was observed in the untreated group . The carotid intima-media thickness at the end of 1-year follow-up was significantly reduced in the nateglinide group compared with the untreated group ( -0.017+/-0.054 mm/year versus 0.024+/-0.066 mm/year , P=0.0064 ) . Whereas nateglinide treatment also reduced triglyceride , highly-sensitive C-reactive protein , and E-selectin , multiple regression analysis identified HbA1c as the only significant independent determinant of the change in carotid intima-media thickness . CONCLUSION In type 2 diabetic patients with good glycemic control , further strict glycemic control by nateglinide results in regression of carotid intima-media thickness .
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Intervention_Pharmacological
Nateglinide
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Intervention_Pharmacological
strict glycemic control
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Intervention_Pharmacological
nateglinide
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Intervention_Control
control group ( no treatment )
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Intervention_Educational
untreated
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Intervention_Pharmacological
strict glycemic control by nateglinide
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Outcome_Physical
carotid intima-media thickening
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Outcome_Physical
carotid far wall intima-media thickness
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Outcome_Physical
HbA1c
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Outcome_Physical
HbA1c
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Outcome_Physical
carotid intima-media thickness
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Outcome_Physical
triglyceride , highly-sensitive C-reactive protein , and E-selectin
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Outcome_Physical
HbA1c
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Outcome_Physical
carotid intima-media thickness
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Outcome_Physical
carotid intima-media thickness
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Participant_Condition
type 2 diabetes
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Participant_Condition
78 drug-naive type 2 diabetic patients whose HbA1c was less than 6.5 % .