Metformin, Vidagliptin Associated With Elevated Heart Rate in Type 2 Diabetes

HealthDay News — For patients with type 2 diabetes, vildagliptin lowers blood pressure (BP) and elevates heart rate, while metformin increases heart rate with no effect on BP during intraduodenal (ID) glucose infusion, according to a study published online in Diabetes Care.

Tongzhi Wu, MD, PhD, from the University of Adelaide in Australia, and colleagues examined the effects of vildagliptin and metformin on BP and heart rate responses to ID glucose in patients with diet-controlled type 2 diabetes. Study A compared vildagliptin and placebo given 60 minutes before a 120-minute ID glucose infusion (at 2 or 4 kcal/min [ID2 and ID4]) in 16 patients, while study B compared metformin and placebo given 30 minutes before ID2 over 120 minutes in 9 patients.

The researchers found that after vildagliptin versus placebo, systolic and diastolic BP were lower (P =.002 and P <.001) and heart rate was higher (P =.005); there was no correlation between vildagliptin and the rate of glucose infusion. Heart rate was increased after metformin versus placebo (P <.001), with no difference in systolic or diastolic BP.

Vildagliptin reduces BP and increases heart rate, whereas metformin increases heart rate without affecting BP during ID glucose infusion in type 2 diabetes,” the authors write. “These distinct cardiovascular profiles during enteral nutrient exposure may have implications for postprandial hypotension.”

Study A was supported by Novartis, which supplied the vildagliptin and matching placebo tablets. Study B was funded by Merck Sharp & Dohme, which arranged the supply of metformin and placebo.

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Wu T, Trahair LG, Little TJ, et al. Effects of vildagliptin and metformin on blood pressure and heart rate responses to small intestinal glucose in type 2 diabetes [published on March 7, 2017]. Diabetes Care. doi: 10.2337/dc16-2391