title: Effects of sitagliptin or mitiglinide as an add-on to acarbose on daily blood glucose fluctuations measured by 72 h subcutaneous continuous glucose monitoring in Japanese patients with type 2 diabetes: a prospective randomized study.
abstract: OBJECTIVE
  Postprandial hyperglycemia and blood glucose fluctuations increase the risk of macroangiopathy in patients with type 2 diabetes mellitus (T2DM). However, few studies have examined the effects of oral hypoglycemic drugs on blood glucose fluctuations in daily life.
  
  
  METHODS
  Twenty-nine T2DM patients treated with acarbose were randomized to receive either sitagliptin (14 patients) or mitiglinide (15 patients) together with acarbose for 4 weeks. Patients were then switched to a combination of 10 mg mitiglinide and 0.2 mg voglibose for 4 weeks. All patients wore a continuous glucose monitoring (CGM) device for 5 - 7 days in week 3 of each treatment period.
  
  
  RESULTS
  The percentage of blood glucose levels in the hyperglycemic range, blood glucose indices derived from 24-h CGM profiles and the glycemic parameters (HbA1c, glycated albumin and fasting plasma glucose) were significantly improved by adding sitagliptin or mitiglinide to ongoing acarbose therapy. These parameters also tended to improve in the mitiglinide/voglibose combination period.
  
  
  CONCLUSIONS
  Daily blood glucose fluctuations were significantly improved by adding sitagliptin or mitiglinide to acarbose, and improved after switching to the mitiglinide/voglibose combination. Larger controlled studies are needed to verify the effects of adding sitagliptin or mitiglinide to acarbose on glucose fluctuations.
authors.affiliation: NakaKinen Clinic , 745-5, Nakadai, Naka, Ibaraki , Japan t-osonoi@kensei-kai.com.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Osonoi
authors.forename: Miyoko
authors.initials: M
authors.lastname: Saito
authors.forename: Atsuko
authors.initials: A
authors.lastname: Tamasawa
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ishida
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Osonoi
mesh_terms: D020909:Acarbose / Q000627:therapeutic use*; D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D017127:Glycation End Products, Advanced; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007294:Inositol / Q000031:analogs & derivatives / Q000627:therapeutic use; D054833:Isoindoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011719:Pyrazines / Q000627:therapeutic use*; D012709:Serum Albumin / Q000032:analysis; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000627:therapeutic use*; D000093423:Glycated Serum Albumin
chemical_list: D001786:Blood Glucose; D017127:Glycation End Products, Advanced; D007004:Hypoglycemic Agents; D054833:Isoindoles; D011719:Pyrazines; D012709:Serum Albumin; D014230:Triazoles; D007294:Inositol; C087255:mitiglinide; C102817:voglibose; D020909:Acarbose; D000068900:Sitagliptin Phosphate; D000093423:Glycated Serum Albumin
keywords: acarbose; blood glucose fluctuations; continuous glucose monitoring; mitiglinide; mitiglinide/voglibose combination; sitagliptin