title: Add-on treatment with teneligliptin ameliorates glucose fluctuations and improves glycemic control index in Japanese patients with type 2 diabetes on insulin therapy.
abstract: BACKGROUND
  This study investigated whether teneligliptin, a novel dipeptidyl peptidase-4 inhibitor, ameliorated glucose fluctuations in hospitalized Japanese patients with type 2 diabetes receiving insulin therapy, with or without other antidiabetes drugs, and using continuous glucose monitoring (CGM).
  
  
  METHODS
  Twenty-six patients with type 2 diabetes were admitted for glycemic control. After admission, patients continued to be treated with optimal dietary therapy plus insulin therapy, with or without other antidiabetes drugs, until they achieved stable glycemic control. CGM measurements were made for 7 consecutive days. On Days 1-3, patients received insulin with or without other antidiabetes drugs, and on Days 4-7, teneligliptin 20 mg once daily at breakfast was added to ongoing therapy. Doses of insulin were fixed during the study. Levels of serum glycated albumin (GA), 1,5-anhydro-d-glucitol (1,5-AG), and high-sensitivity C-reactive protein (hsCRP) were measured.
  
  
  RESULTS
  Add-on treatment with teneligliptin led to significant improvements in 24-h mean glucose levels, the proportion of time in normoglycemia, mean amplitude of glycemic excursions, and total area under the curve within 2 h after each meal. The proportion of time in hypoglycemia and hsCRP levels did not increase significantly compared with before teneligliptin. Values of 1,5-AG and GA were significantly improved by treatment with teneligliptin.
  
  
  CONCLUSIONS
  Addition of teneligliptin to insulin therapy led to a significant improvement in diurnal glycemic control and significant reductions in glucose fluctuations in 24-h periods without increasing hypoglycemia in Japanese patients with type 2 diabetes on insulin therapy, with or without other antidiabetes agents.
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University , Tochigi, Japan .
authors.forename: Seiichi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Chie
authors.initials: C
authors.lastname: Aoki
authors.forename: Mai
authors.initials: M
authors.lastname: Niitani
authors.forename: Kanako
authors.initials: K
authors.lastname: Kato
authors.forename: Takanori
authors.initials: T
authors.lastname: Tomotsune
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Aso
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003131:Combined Modality Therapy / Q000009:adverse effects; D003847:Deoxyglucose / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy*; D003927:Diet, Diabetic; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance; D018432:Drug Resistance, Multiple; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D017127:Glycation End Products, Advanced; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D010865:Pilot Projects; D011446:Prospective Studies; D011720:Pyrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D012709:Serum Albumin / Q000032:analysis; D053778:Thiazolidines / Q000009:adverse effects / Q000627:therapeutic use*; D000093423:Glycated Serum Albumin
chemical_list: C579035:3-(4-(4-(3-methyl-1-phenyl-1H-pyrazol-5-yl)piperazin-1-yl)pyrrolidin-2-ylcarbonyl)thiazolidine; D054873:Dipeptidyl-Peptidase IV Inhibitors; D017127:Glycation End Products, Advanced; D007004:Hypoglycemic Agents; D007328:Insulin; D011720:Pyrazoles; D012709:Serum Albumin; D053778:Thiazolidines; C006584:1,5-anhydroglucitol; D002097:C-Reactive Protein; D003847:Deoxyglucose; D000093423:Glycated Serum Albumin