Therapeutic Efficacy of Mitiglinide Combined with Once Daily Insulin Glargine after Switching from Multiple Daily Insulin Regimen of Aspart Insulin and Glargine in Patients with Type 2 Diabetes Mellitus

Endocrine Journal

Yoshie KANAZAWA¹  Fumihiko SATO¹  Tomoya MITA¹  Rei KANNO¹  Ken SAKAI¹  Yuko SAKURAI¹  Shinya MIWA¹  Tomoaki YOSHIHARA¹  Kanako HARA¹  Junko KAWAI¹  Naoki KUMASHIRO¹  Ryuzo KAWAMORI¹  Hiroshi UCHINO¹  Hirotaka WATADA¹  Akio KANAZAWA¹  Tomoaki SHIMIZU¹  Yuka YAMAZAKI¹  Michiko ABE¹  Kayoko MOTOJIMA¹  Yasushi TANAKA¹  Takahisa HIROSE¹ 

[1] Department of Medicine, Metabolism and Endocrinology, Juntendo University, School of Medicine

关键词: Oral antidiabetic drugs;    Combination therapy;    Postprandial hyperglycemia;   

DOI  :  10.1507/endocrj.53.67

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(21)Cited-By(15)Mitiglinide is novel class of rapid-acting insulin secretagogues, which have been widely used alone or in combination with other oral hypoglycemic drugs to improve postprandial hyperglycemia in early type 2 diabetes. While mitiglinide enhances postprandial requirement of insulin, the efficacy of mitiglinide combined with insulin has yet to be established. We investigated the efficacy of mitiglinide combined with insulin glargine, the first soluble insulin analog that has a flat and prolonged effect. After control with the intensive regimen (daily aspart insulin and glargine), 30 inpatients with type 2 diabetes were switched to premeal mitiglinide combined with once daily insulin glargine (mitiglinide regimen), and daily profiles of blood glucose level were compared under each regimen. Fifteen patients showed similar control of hyperglycemia with mitiglinide regimen and intensive insulin regimen, assessed by M value (<32), while the remaining 15 showed worsening under the mitiglinide regimen. The patients who were well controlled with mitiglinide regimen were significantly younger (51.9 ± 16.0 years, p<0.005) and heavier (body mass index: 25.7 ± 3.3 kg/m2, p<0.05) than those who were not (67.9 ± 8.7 and 23.0 ± 3.1, respectively). Moreover, insulin doses of aspart per body weight were significantly fewer in effective group than in ineffective group. Duration of diabetes was shorter in the effective group, albeit insignificantly. Previous treatment before starting intensive insulin regimen, such as insulin and sulfonylurea, was not different between the two groups. Our results suggest that mitiglinide plus insulin glargine combination therapy is useful for lowering both fasting and postprandial hyperglycemia in a subpopulation of type 2 diabetes. The long-term effects of such treatment need to be established in future studies.

【 授权许可】

Unknown