title: Add-on treatment with mitiglinide improves residual postprandial hyperglycemia in type 2 diabetic patients receiving the combination therapy with insulin glargine and sitagliptin.
abstract: The combination of a dipeptidyl peptidase-4 (DPP-4) inhibitor and a long-acting insulin analogue is widely used in clinical practice. However, some patients fail to achieve lower postprandial hyperglycemia. Mitiglinide, a short-acting insulinotropic sulfonylurea receptor ligand, is effective for postprandial hyperglycemia. Recently, it has been reported that the combination therapy of mitiglinide with a DPP-4 inhibitor could improve glycemic control. However, the efficacy of those under long-acting insulin analogue therapy remains to be investigated. Thus, we conducted a prospective single-center study of eight Japanese patients with type 2 diabetes mellitus receiving mitiglinide added to the combination therapy of sitagliptin and insulin glargine, and evaluated its efficacy and safety by continuous glucose monitoring (CGM). Participants' (four men and four women) mean age was 70.3 ± 10.6 years. Their mean body mass index, HbA1c level, and urinary C-peptide level were 22.0 ± 2.8 kg/m(2), 9.2 ± 1.2%, and 50.0 ± 31.4 μg/day, respectively. CGM showed that as compared with the combination of only sitagliptin and insulin glargine, mitiglinide in combination with sitagliptin and insulin glargine significantly reduced glycemic fluctuation indices, total area for the range of 24-h glycemic fluctuations (p = 0.04), mean amplitude of glycemic excursions (p = 0.03), and the proportion of time in hyperglycemia (p = 0.02) without significant difference in the proportion of time in hypoglycemia (p = 0.18). Hence, we have demonstrated the efficacy and safety of the add-on treatment with mitiglinide in type 2 diabetic patients, receiving the combination therapy of sitagliptin and insulin glargine.
authors: Department of Diabetes and Endocrinology, Osaka Red Cross Hospital.
authors: Takaaki
authors: T
authors: Murakami
authors: Takuo
authors: T
authors: Nambu
authors: Tomoko
authors: T
authors: Kato
authors: Yuki
authors: Y
authors: Matsuda
authors: Shin
authors: S
authors: Yonemitsu
authors: Seiji
authors: S
authors: Muro
authors: Shogo
authors: S
authors: Oki
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D000069036:Insulin Glargine / Q000627:therapeutic use*; D054833:Isoindoles / Q000627:therapeutic use*; D008297:Male; D008991:Monitoring, Physiologic; D000068900:Sitagliptin Phosphate / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D054833:Isoindoles; D000069036:Insulin Glargine; C087255:mitiglinide; D000068900:Sitagliptin Phosphate