Bedtime NPH Insulin Reduced the Expression of Serum miRNAs Related to Insulin Resistance in Comparison to DPP-4 Inhibitor Sitagliptin in Patients with T2DM

Introduction and Objective: miRNAs and their target genes may unravel mechanisms of action of medications and identify therapeutic biomarkers. We evaluated the effect of treatment with bedtime NPH insulin or sitagliptin on serum miRNAs expression of patients with T2D Methods: Thirty-two patents with T2D inadequately controlled with metformin and glibenclamide were randomly assigned to 6-month complementary treatment with bedtime NPH insulin or sitagliptin. At baseline and after treatments, glucose, C-peptide,GLP-1, and triglycerides were determined at fasting and 60, 120 and 180min after a meal. HbA1c levels at fasting. Analyses used Student's t-test Results: Sitagliptin (n=16) and bedtime NPH insulin (n=16) groups did not differ in age, body mass index, diabetes duration, and metabolic data. There was a similar HbA1c reduction in both groups. Sitagliptin increased postprandial GLP-1 levels. NPH insulin increased fasting insulin levels. In comparison to sitagliptin, NPH insulin determined lower expression of miR-24-3p (times 0, 60,120 and 180min), of let-7d-5p (60, 120 and 180min), of miR-660-5p (60min) and of miR-27a-3p(120min) post meal (p<0.05). Conclusion: 6-month treatment with NPH insulin or sitagliptin improved glycemic control. NPH insulin determined lower values ​​of miRNAs related to insulin resistance Disclosure: A.S. Santos: None. S.Y. Bando: None. M. Correa-Giannella: None. M. Rossi: None. Funding: Sao Paulo Research Foundation (2022/16441-5); Faculdade de Medicina da USP