Comparison of the hypoglycemic effect of sitagliptin versus the combination of mitiglinide and voglibose in drug-naïve Japanese patients with type 2 diabetes.
OBJECTIVE
The postprandial glucose (PPG) level is reduced by α-GIs, glinides and DPP4Is through different pharmacological actions. The aim of this study was to compare the effect of sitagliptin (S) versus that of the combination of mitiglinide and voglibose (M+V) on markers of glycemic control.


METHODS
A randomized cross-over trial was performed in 20 patients with drug-naïve type 2 diabetes. The patients were randomized to receive S (50 mg/day) or M+V (1 tablet 3 times daily). Treatment was continued for 8 weeks, after which they were switched to the other regimen and treated for another 8 weeks. At baseline, after the first regimen, and after the second regimen, a meal test was performed.


METHODS
The markers of glycemic control were examined.


RESULTS
Reduction of glucose excursion was significantly greater with M+V than with S. HbA1c did not change with either regimen. However, 1,5-anhydroglucitol showed a significant increase from baseline with both regimens (7.9 ± 4.3 μg/ml at baseline vs. 10.6 ± 5.5 with S, p < 0.05 and 15.1 ± 6.2 with M+V, p < 0.01). Compared with baseline, glycoalbumin was significantly reduced by M+V, but not S (19.6 ± 2.9% at baseline vs. 17.3 ± 3.8% with M+V, p < 0.05).


CONCLUSIONS
M+V achieved better control of PPG excursion than S.
St. Marianna University School of Medicine, Division of Metabolism and Endocrinology, Department of Internal Medicine , 2-16-1, Sugao, Miyamae-ku, Kawasaki, 216-8511 , Japan a2oota@marianna-u.ac.jp.
Akio
A
Ohta
Toshihiko
T
Ohshige
Kensuke
K
Sakai
Yuta
Y
Nakamura
Ayumi
A
Tenjin
Shuichi
S
Tsukiyama
Yuko
Y
Terashima
Fumiaki
F
Matsubara
Takehiro
T
Kawata
Yoshio
Y
Nagai
Yasushi
Y
Tanaka
D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000032:analysis; D018592:Cross-Over Studies; D003847:Deoxyglucose / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004338:Drug Combinations; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D017127:Glycation End Products, Advanced; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007294:Inositol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007328:Insulin / Q000097:blood; D054833:Isoindoles / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011719:Pyrazines / Q000008:administration & dosage*; D012709:Serum Albumin / Q000032:analysis; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000008:administration & dosage*; D000093423:Glycated Serum Albumin
D001786:Blood Glucose; D003847:Deoxyglucose; D004338:Drug Combinations; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D007004:Hypoglycemic Agents; D007294:Inositol; D007328:Insulin; D054833:Isoindoles; D011719:Pyrazines; D012709:Serum Albumin; D000068900:Sitagliptin Phosphate; D014230:Triazoles; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human; C006584:1,5-anhydroglucitol; C087255:mitiglinide; C102817:voglibose