Efficacy and safety of sitagliptin in Japanese patients with type 2 diabetes switched from glinides.
OBJECTIVE
The efficacy and safety of sitagliptin, a dipeptidyl peptidase (DPP)-4 inhibitor, were compared with those of glinides in Japanese patients with type 2 diabetes.


METHODS
The participants were 82 patients with type 2 diabetes (glycated hemoglobin [HbA1c] ≥6.0% and <10%) under treatment with glinides for glucose control. The participants were randomly assigned to a group (n = 44) receiving continuous treatment with glinides and a group (n = 38) switched to sitagliptin. Patients were followed for 12 weeks to evaluate glucose control. A meal tolerance test was carried out in weeks 0 and 12 to examine the pancreatic secretory response to postprandial hyperglycemia.


RESULTS
The changes in HbA1c from week 0 to week 12 were -0.25 and -0.05% in the sitagliptin and glinide groups, respectively, with a significant improvement with sitagliptin. The differences in fasting plasma glucose (FPG), glycoalbumin and 1,5-anhydroglucitol between the two groups were 14.2 mg/dL, 0.7% and 1.7 μg/mL, respectively, showing significant improvements with sitagliptin. In the meal tolerance test, glucose at 0 min was lower in the sitagliptin group; however, there were no differences in glucose elevation at 30 and 60 min compared with 0 min. Plasma insulin and glucagon secretion at week 12 were significantly lower than at baseline in the sitagliptin group. Adverse events including hypoglycemia did not differ between the groups.


CONCLUSIONS
FPG decreased and glucose control improved in patients who switched from glinides to sitagliptin. Sitagliptin decreased secretion of insulin and glucagon in a meal tolerance test compared with glinides, whereas the agents showed similar inhibition of postprandial hyperglycemia. This trial was registered with UMIN (UMIN-CTR no. 000003479).
Department of Internal Medicine National Hospital Organization Mie Chuo Medical Center Tsu Japan.
Tsuyoshi
T
Tanaka
Department of Internal Medicine National Hospital Organization Mie Chuo Medical Center Tsu Japan.
Hiroyuki
H
Goto
Department of Internal Medicine National Hospital Organization Mie National Hospital Tsu Japan.
Rika
R
Araki
Department of Internal Medicine National Hospital Organization Mie Chuo Medical Center Tsu Japan.
Mika
M
Yamamoto
Department of Internal Medicine National Hospital Organization Mie Chuo Medical Center Tsu Japan.
Takashi
T
Tanaka
Department of Internal Medicine Ise Red Cross Hospital Ise Japan.
Ryoko
R
Fujiwara
Department of Internal Medicine Ise Red Cross Hospital Ise Japan.
Kazuya
K
Murata
Glinides; Sitagliptin; Type 2 diabetes