Predictive factors of durability to sitagliptin: Slower reduction of glycated hemoglobin, older age and higher baseline glycated hemoglobin.
OBJECTIVE
The goal of the present study was to evaluate predictive factors for good efficacy and durability to sitagliptin with ongoing metformin or metformin plus glimepiride therapy in a real practice situation. The present observational study was carried out over a 60-week period and involved Korean patients with type 2 diabetes mellitus.


METHODS
A total of 100 mg of sitagliptin were added once daily to the two most popular therapy regimens (group 1: metformin, group 2: metformin plus glimepiride). Before adding sitagliptin, mean initial glycated hemoglobin (HbA1c) levels were 7.8% (62 mmol/mol) and mean diabetes duration was 8.3 years.


RESULTS
After 60 weeks, the mean change in HbA1c from baseline was -0.9% (-10 mmol/mol) in group 1 and -1.0% (-11 mmol/mol) in group 2. Decreased HbA1c levels were significantly associated with higher initial HbA1c and lower log-transformed C-peptide levels in a multivariate regression analysis. Logistic regression analysis showed that a sustained reduction in HbA1c levels after 12 weeks was significantly associated with older age (≥60 years), higher baseline HbA1c (group 1 ≥ 7.0% [53 mmol/mol], group 2 ≥ 7.5% [58 mmol/mol]) and slower reduction of HbA1c (ΔHbA1c <1.0% [11 mmol/mol]) in group 1 and group 2. In group 2, a higher ratio of reduction of postprandial glucose/reduction of fasting plasma glucose (ΔPPG/ΔFPG) during 12 weeks was also associated with a sustained reduction in HbA1c levels after 12 weeks.


CONCLUSIONS
The effects of sitagliptin lasted more than 12 weeks in older patients with a higher baseline HbA1c, and slower reduction of HbA1c during 12 weeks.
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Changwon Hospital Sungkyunkwan University School of Medicine Gyeongsangnam-do Korea.
Hye Soo
HS
Chung
Division of Endocrinology and Metabolism Department of Internal Medicine Dong-A University Medical Center Busan Korea.
Sunghwan
S
Suh
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Mi Yeon
MY
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Soo Kyoung
SK
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Hee Kyung
HK
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Ji In
JI
Lee
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Kyu Yeon
KY
Hur
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Jae Hyeon
JH
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Yong-Ki
YK
Min
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Myung-Shik
MS
Lee
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Kwang-Won
KW
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Sun Wook
SW
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Jae Hoon
JH
Chung
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.
Moon-Kyu
MK
Lee
Durability; Predictive factors; Sitagliptin