title: Efficacy of sitagliptin on blood glucose fluctuation in Japanese type 2 diabetic patients with basal-supported oral therapy.
abstract: We retrospectively investigated the effect of adding dipeptidyl peptidase-4 (DPP-4) inhibitor and tapering sulfonylurea on blood glucose fluctuation in Asian patients with type 2 diabetes mellitus under basal-supported oral therapy (BOT).  We recruited twenty-two consecutive Japanese patients with type 2 diabetes mellitus who had blood glucose fluctuation under the combination therapy of insulin glargine and glimepiride and had sitagliptin initiated with glimepiride tapared.  Their hemoglobin A1c levels and mean blood glucose profiles of seven points in self-monitoring blood glucose (SMBG) were 7.4 ± 0.6% and 8.6 ± 2.0 mmol/L, respectively.  Sitagliptin was initiated with the dose of 50 mg per day and titrated up to 100 mg per day when necessary.  Glimepiride was withdrawn if possible.  Blood glucose fluctuation was evaluated with SMBG by calculating M-value, its range (the difference of maximum and minimum blood glucose levels), and its coefficient of variation (CV).  Two months after sitagliptin add-on, M-value was decreased from 19 ± 13 to 13 ± 8 (p = 0.04).  Blood glucose range and CV were also improved from 9.6 ± 2.9 mmol/L to 7.9 ± 2.6 mmol/L (p = 0.01), and from 33 ± 8% to 29 ± 8% (p < 0.01), respectively.  Hemoglobin A1c levels and mean blood glucose profiles were unchanged (p = 0.93 and 0.47).  In conclusion, blood glucose fluctuation was significantly improved two months after adding sitagliptin and tapering glimepiride in type 2 diabetic Japanese patients who were treated by BOT with insulin glargine and glimepiride.
authors: Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Mitsuyoshi
authors: M
authors: Takahara
authors: Toshihiko
authors: T
authors: Shiraiwa
authors: Hideaki
authors: H
authors: Kaneto
authors: Naoto
authors: N
authors: Katakami
authors: Taka-Aki
authors: TA
authors: Matsuoka
authors: Iichiro
authors: I
authors: Shimomura
mesh_terms: D000284:Administration, Oral; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011719:Pyrazines / Q000008:administration & dosage* / Q000494:pharmacology*; D012189:Retrospective Studies; D000068900:Sitagliptin Phosphate; D013453:Sulfonylurea Compounds / Q000008:administration & dosage*; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage* / Q000494:pharmacology*
chemical_list: D001786:Blood Glucose; D004338:Drug Combinations; D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D011719:Pyrazines; D013453:Sulfonylurea Compounds; D014230:Triazoles; D000069036:Insulin Glargine; C057619:glimepiride; D000068900:Sitagliptin Phosphate