title: Both glimepiride and high-dose metformin are important for sustained glucose lowering in Japanese type 2 diabetes patients on glimepiride-sitagliptin-metformin therapy: subanalysis of a single-center, open-label, randomized study.
abstract: BACKGROUND
  In a previous single-center, open-label randomized 3-month study of triple oral antidiabetes drug (OAD) therapy, we investigated factors affecting the glycemic control afforded by sitagliptin, high-dose metformin, and low-dose glimepiride. Patients were prospectively assigned to either Group 1 (50% reduction in metformin) or Group 2 (discontinuation of glimepiride) and compared. The results showed that the glycated hemoglobin (HbA1c) levels of patients in Group 2 deteriorated more than those in Group 1, whereas HbA1c levels were maintained in some patients in both groups.
  
  
  METHODS
  To determine the factors associated with maintenance of HbA1c under this triple OAD regimen, data from the prospective study were further analyzed.
  
  
  RESULTS
  In both Groups 1 and 2, the baseline HbA1c level was higher in patients with HbA1c ≥7.0% after 3 months of treatment than those with an HbA1c level of <7.0%. A generalized linear model revealed that high-dose metformin was associated with a deterioration of HbA1c levels in Group 2.
  
  
  CONCLUSIONS
  Together, the findings indicate that glimepiride and high-dose metformin are important for sustained glycemic control in triple OAD therapy with sitagliptin, metformin, and sulfonylurea.
authors: 1 Arai Clinic , Yokohama, Japan .
authors: Keiko
authors: K
authors: Arai
authors: Hajime
authors: H
authors: Maeda
authors: Shin-ichiro
authors: S
authors: Shirabe
authors: Ritsuko
authors: R
authors: Yamamoto
authors: Atsushi
authors: A
authors: Kumakura
authors: Mikio
authors: M
authors: Yamauchi
authors: Tetsuyuki
authors: T
authors: Hirao
authors: Setsuko
authors: S
authors: Hirao
authors: Koichi
authors: K
authors: Hirao
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; 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*; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011719:Pyrazines / Q000627:therapeutic use*; D000068900:Sitagliptin Phosphate; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin; D011719:Pyrazines; D000068900:Sitagliptin Phosphate; D013453:Sulfonylurea Compounds; D014230:Triazoles; C517652:hemoglobin A1c protein, human; C057619:glimepiride