Comparison of efficacy of concomitant administration of mitiglinide with voglibose and double dose of mitiglinide in patients with type 2 diabetes mellitus.
Aims/Introduction:  When monotherapy with an oral hypoglycemic agent (OHA) is not sufficiently effective for blood glucose control, combination therapy with OHA having different mechanisms of action might be indicated.


METHODS
In the present study, we compared the efficacy of two options in type 2 diabetes mellitus patients whose blood glucose had not been well controlled with mitiglinide (30 mg/day) alone. A total of 20 patients were included in the study and divided into two groups: group A, in which mitiglinide was given concomitantly with the α-glucosidase inhibitor voglibose (0.6 mg/day); and group B, in which a double dose of mitiglinide was given (60 mg/day). Twelve weeks after changing the medication, HbA1c, glycoalbumin and 1,5-anhydroglucitol (1,5-AG) were measured. In addition, at weeks 0 and 12, a meal tolerance test was carried out, and plasma glucose, insulin, glucagon, active glucagon-like peptide-1 (GLP-1) and total glucose-dependent insulinotropic polypeptide levels were measured.


RESULTS
The plasma level of 1,5-AG improved in both groups at week 12. In group A, the plasma insulin level significantly decreased and the plasma active GLP-1 level significantly increased during the meal tolerance test at week 12; thus, bodyweight significantly decreased only in group A.


CONCLUSIONS
Our findings suggested that concomitant administration of mitiglinide with voglibose could achieve better glycemic control, particularly in the postprandial period, without bodyweight gain and might have beneficial effects in type 2 diabetic patients at risk of macrovascular complications. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2010.0082.x, 2011).
Divisions of Diabetes and Metabolism and.
Tomoyuki
T
Katsuno
Innovative Diabetes Treatment, Department of Internal Medicine, Hyogo College of Medicine.
Nobuaki
N
Watanabe
Divisions of Diabetes and Metabolism and.
Etsuko
E
Nagai
Innovative Diabetes Treatment, Department of Internal Medicine, Hyogo College of Medicine.
Kazumi
K
Okazaki
Innovative Diabetes Treatment, Department of Internal Medicine, Hyogo College of Medicine.
Ariko
A
Yokoyama
Watanabe Medical Clinic, Nishinomiya, Hyogo, Japan.
Tomoya
T
Hamaguchi
Divisions of Diabetes and Metabolism and.
Jun-Ichiro
J
Miyagawa
Divisions of Diabetes and Metabolism and.
Mitsuyoshi
M
Namba
Glucagon‐like peptide‐1; Mitiglinide; α‐Glucosidase inhibitor