title: Glycemic/metabolic responses to identical meal tolerance tests at breakfast, lunch and dinner in Japanese patients with type 2 diabetes mellitus treated with a dipeptidyl peptidase-4 inhibitor and the effects of adding a mitiglinide/voglibose fixed-dose combination.
abstract: BACKGROUND
  The effects of the mitiglinide/voglibose fixed-dose combination on postprandial glycemic/metabolic responses in patients with type 2 diabetes mellitus (T2DM) treated with dipeptidyl peptidase-4 (DPP-4) inhibitors are unknown.
  
  
  METHODS
  Twelve T2DM patients treated with a DPP-4 inhibitor underwent identical meal tolerance tests (MTTs) at breakfast, lunch and dinner, before and 2 - 3 weeks after treatment with a fixed-dose combination of mitiglinide 10 mg and voglibose 0.2 mg (combination). Patients were randomized in a cross-over fashion to administer the combination either three-times-daily before each meal or twice-daily before breakfast and dinner. Glycemic/metabolic responses were evaluated at 0, 30, 60 and 120 min in each MTT.
  
  
  RESULTS
  Three-times-daily administration of the combination significantly suppressed postprandial hyperglycemia after each meal, particularly after lunch and dinner. Active glucagon-like peptide-1 levels increased significantly after each meal, as did early-phase insulin secretion without excessive insulin secretion. Postprandial hyperglycemia after lunch was significantly greater after twice-daily than three-times-daily administration, but there were no clinically relevant differences in other metabolic responses.
  
  
  CONCLUSIONS
  This study revealed that adding the mitiglinide/voglibose combination to a DPP-4 inhibitor elicited additive improvements in postprandial glycemic/metabolic responses assessed using MTTs at breakfast, lunch and dinner with identical meal compositions.
authors.affiliation: Yuri Ono Clinic, Diabetes, Internal Medicine , Sapporo Kita-1 Ekimaedori Building 7F, 3-27; Nishi-3, Kita-1, Chuo-ku, Sapporo 060-0001 , Japan +81 11 223 5152 ; +81 11 223 5153 ; yuriono@ja2.so-net.ne.jp.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Ono
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kamoshima
authors.forename: Akinobu
authors.initials: A
authors.lastname: Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nomoto
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D062408:Breakfast; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy* / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007294:Inositol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D054833:Isoindoles / Q000627:therapeutic use*; D062409:Lunch; D008297:Male; D062407:Meals; D008875:Middle Aged; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose; D054873:Dipeptidyl-Peptidase IV Inhibitors; D004338:Drug Combinations; D007004:Hypoglycemic Agents; D007328:Insulin; D054833:Isoindoles; D007294:Inositol; D052216:Glucagon-Like Peptide 1; C087255:mitiglinide; C102817:voglibose
keywords: dipeptidyl peptidase-4 inhibitor; glycemic response; meal tolerance tests; mitiglinide/voglibose fixed-dose combination; type 2 diabetes mellitus