Effect of sitagliptin on glycemic control and beta cell function in Japanese patients given basal-supported oral therapy for type 2 diabetes

Endocrine Journal

Yoshiyuki Sada²  Akihiko Kondo²  Yoshio Nagai²  Toshiyasu Sasaoka¹  Akio Ohta²  Shiko Asai²  Yasushi Tanaka²  Hiroyuki Kato² 

[1] Department of Clinical Pharmacology, University School of Toyama, Toyama 930-0194, Japan;Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan

关键词: Type 2 diabetes mellitus;    BOT;    DPP-4 inhibitor;    Sitagliptin;    Proinsulin/C-peptide ratio;   

DOI  :  10.1507/endocrj.EJ14-0194

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(28)We evaluated the effect of sitagliptin on glycemic control, endogenous insulin secretion, and beta cell function in Japanese patients with type 2 diabetes mellitus (T2DM) receiving a combination of oral antidiabetics and basal insulin analog glargine (basal-supported oral therapy [BOT]).Twenty-one patients showing inadequate glycemic control with BOT were given dipeptidylpeptidase-4 inhibitor (DPP-4I) sitagliptin at 50 mg/day for 12 weeks.Clinical markers of glycemic control, HbA1c, glycated albumin (GA), and 1,5-anhydroglucitol (1,5-AG), were measured before and 4 and 12 weeks after the start of sitagliptin.A 2-hour morning meal test was performed upon enrollment and at 12 weeks, and plasma glucose (PG), serum C-peptide, and plasma intact proinsulin (PI) were measured.HbA1c, GA, and 1,5-AG at 4 and 12 weeks were significantly improved over enrollment levels.The area under the PG concentration curve (AUC-PG) during the meal test at 12 weeks was significantly reduced (from 350 ± 17 mg �? hr/dL before sitagliptin treatment to 338 ± 21 mg �? hr/dL [mean ± SE], P < 0.05,); the AUC-C-peptide was unchanged (from 3.4 ± 0.4 ng �? hr/mL to 3.6 ± 0.5 ng �? hr/mL).However, both fasting and 2-hour PI/C-peptide ratios at 12 weeks were significantly decreased (from 13.3 ± 2.3 to 11.1 ± 2.0 [P < 0 .05] and from 9.5 ± 1.6 to 5.3 ± 0.9 [P < 0.01], respectively).Adding sitagliptin to BOT in Japanese T2DM patients appears to improve glycemic control without increasing endogenous insulin secretion and to reduce fasting and 2-hour postprandial PI/C-peptide ratios.

【 授权许可】

Unknown