title: Efficacy of combination therapy with sitagliptin and low-dose glimepiride in Japanese patients with type 2 diabetes.
abstract: BACKGROUND
  We examined the effects of combination therapy with 50 mg/day of sitagliptin and low-dose glimepiride (1 mg/day) in patients with type 2 diabetes.
  
  
  METHODS
  Twenty-six patients with poorly controlled type 2 diabetes currently taking high-dose glimepiride (≥ 2 mg/day) were enrolled in the study. The dose of glimepiride was reduced to 1 mg/day and 50 mg/day of sitagliptin was added without changing the doses of any other antihyperglycemic agents. The patients were divided into two groups: the low-dose group (2 or 3 mg glimepiride decreased to 1 mg: n = 15) and the high-dose group (4 or 6 mg glimepiride decreased to 1 mg: n = 11).
  
  
  RESULTS
  Combination therapy significantly lowered HbA1c after 24 weeks of treatment in both groups. In the low-dose group, 8.1 ± 0.2% decreased to 7.0 ± 0.1%; in the high-dose group, 8.4 ± 0.1% decreased to 7.3 ± 0.2%. The time course of the degree of HbA1c reduction in the high-dose group was almost superimposable on that in the low-dose group. There were no changes in body weight and no hypoglycemia and in either group during the study period. In conclusion, our results suggested that the combination therapy used in the study is both well tolerated and effective.
  
  
  CONCLUSIONS
  This study indicated the usefulness of dipeptidyl peptidase (DPP)-4 inhibitors in Japanese patients with type 2 diabetes, and also reinforces the importance of low doses of sulfonylurea for effective glycemic management.
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Shinshu University School of Medicine, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Shinshu University School of Medicine, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ohkubo
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Shinshu University School of Medicine, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takei
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Shinshu University School of Medicine, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nishio
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Shinshu University School of Medicine, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamazaki
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Shinshu University School of Medicine, Japan.
authors.forename: Mieko
authors.initials: M
authors.lastname: Kumagai
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Shinshu University School of Medicine, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Shinshu University School of Medicine, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: National Hospital Organization Matsumoto Medical Center, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Aoki
authors.affiliation: Miyamoto Medical Clinic, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Kakizawa Medical Clinic, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kakizawa
authors.affiliation: Ina Central Hospital, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sakuma
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Shinshu University School of Medicine, Japan.
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Komatsu
keywords: Antihyperglycemicagents; Combination therapy; Dipeptidyl peptidase (DPP)-4 inhibitors; Glimepiride; Hypoglycemia; Sitagliptin; Sulfonylurea; Type 2 diabetes mellitus