title: Differences between Mitiglinide/Voglibose Fixed-dose Combination and Glimepiride in Modifying Low-density Lipoprotein Heterogeneity in Japanese Type-2 Diabetic Patients: A Pilot Study.
abstract: OBJECTIVE
  The purpose of this study was to compare the effects of mitiglinide/voglibose fixed-dose combination and glimepiride on low-density lipoprotein (LDL)-heterogeneity in type-2 diabetic patients with unstable glycemic control after treatment with dipeptidyl peptidase-4 (DPP-4) inhibitors.
  
  
  METHODS
  This was an open-label pilot study in which type-2 diabetic patients were randomly assigned to the mitiglinide/voglibose (fixed-dose combination of mitiglinide 10 mg and voglibose 0.2 mg, n=14) or glimepiride (0.5 mg, n=16).
  
  
  RESULTS
  In the glimepiride group, serum LDL cholesterol (LDL-C) and small-dense (sd) LDL levels decreased significantly (-8.5% and -9.0%), while sd-LDL/LDL-C and an indicator of LDL-particle size, LDL-C/apoB, did not change significantly. In the mitiglinide/voglibose group, serum LDL-C levels did not change, while sd-LDL levels and sd-LDL/LDL-C decreased significantly (-8.6% and -7.9%) and LDL-C/apoB increased significantly (5.8%). Fasting blood glucose levels tended to be reduced to a greater extent in the glimepiride group than in the mitiglinide/voglibose group (-13.9% vs. -8.4%, p=0.08), while the rate of reduction of HbA1c levels tended to be higher in the mitiglinide/voglibose group than in the glimepiride group (-6.9% vs. -3.4%, p=0.09), suggesting differences in fluctuating blood glucose levels between the 2 groups.
  
  
  CONCLUSIONS
  There were differences in the effects of mitiglinide/voglibose fixed-dose combination and glimepiride in addition to DPP-4 inhibitors on LDL-metabolism, and this may be related to fluctuations in blood glucose levels after treatment with these agents.
authors.affiliation: Department of Health Planning Center, Nihon University Hospital, Tokyo Japan.
authors.forename: S
authors.initials: S
authors.lastname: Tani
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nagao
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo Japan.
authors.forename: A
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004338:Drug Combinations; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology; D007294:Inositol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D054833:Isoindoles / Q000008:administration & dosage* / Q000494:pharmacology*; D007564:Japan; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D010865:Pilot Projects; D013453:Sulfonylurea Compounds / Q000494:pharmacology*
chemical_list: D001786:Blood Glucose; D004338:Drug Combinations; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007294:Inositol; D054833:Isoindoles; D008077:Lipoproteins, LDL; D013453:Sulfonylurea Compounds; C517652:hemoglobin A1c protein, human; C057619:glimepiride; C087255:mitiglinide; C102817:voglibose