R230C and C230C Variants of ABCA1 and Glyburide Response

Effect of the R230C Variant of the ATP-binding Cassette Transporter A1 (ABCA1) Gene on the Response to Treatment With Glibenclamide in Patients With Type 2 Diabetes Mellitus

The objective of the study is to know if the R230C and C230C variants of the ATP-binding cassette transporter A1 (ABCA1) gene are associated with a smaller glucose lowering effect compared to the wild type allele (R230R) in patients with type 2 diabetes.

Specific objectives:

1. In patients with type 2 diabetes stratified by the existence of the risk alleles (R230C/C230C) or the wild variant (R230R) of ABC-A1, compare the changes resulting from the treatment with glibenclamide on following continuous variables:

   • Fasting glucose
   • Percentage reduction
   • Hemoglobin A1c,
   • Cholesterol, triglycerides, HDL cholesterol, LDL cholesterol
   • Weight

2. In patients with type 2 diabetes stratified by the existence of the risk alleles (R230C/C230C) or the wild variant (R230R) of ABC-A1, compare the changes resulting from the treatment with glibenclamide on following binomial variables:

   • Number of cases that reach fasting plasma glucose lower than 110 mg/dl
   • Number of cases that reach an HbA1c less than 7%

Inclusion Criteria:

• Adults 20 to 79 years
• Body mass index >18 and 39.9 ≤
• Men or women
• Mexicans mestizos.
• Moderate hyperglycemia (126 to 250 mg/dl and HbA1c levels between 7 and 10%) despite being treated with a dietary program in combination or not with metformin (2 g/d).

Exclusion Criteria:

• Patients with chronic complications of diabetes: ischemic heart disease, stroke, proliferative retinopathy or blindness, albuminuria, chronic diarrhea, gastroparesis, non-traumatic amputation of lower limbs.
• Patients with any monogenic syndrome, obesity, diabetes or hypoalphalipoproteinemia
• Patients with acquired diseases that produce secondarily obesity or diabetes.
• Treatment with anorexigenics or accelerate weight loss at the time of the selection.
• Cardiovascular event in the 6 months prior to study entry.
• Steroids, chemotherapy, immunosuppressive or radiotherapy.
• Infections or concurrent acute diseases.
• Catabolic diseases such as cancer or AIDS
• Pregnancy