Which oral antidiabetic drug to combine with metformin to minimize the risk of hypoglycemia when initiating basal insulin?: A randomized controlled trial of a DPP4 inhibitor versus insulin secretagogues.
We conducted a pilot study to evaluate two therapeutic strategies at the time of insulin initiation in type 2 diabetic patients insufficiently controlled with metformin+insulin-secretagogues (IS, sulfonylureas or glinides). Patients were randomized to remain under the same dual therapy or to receive metformin+DPP4 inhibitors while starting insulin. Similar glycemic control was achieved in both groups. However less hypoglycemia was observed with DPP4 inhibitors despite higher doses of insulin.
Diabetes, Endocrinology and Nutrition Department, Lariboisière Hospital, Paris, France.
J F
JF
Gautier
Medical Office, Brest, France.
P
P
Monguillon
Diabetes, Endocrinology and Nutrition Department, Jean Bernard Hospital, Valenciennes, France.
O
O
Verier-Mine
Endocrinology, Diabetology and Nutrition Department, Jean Verdier Hospital, APHP, Paris Nord University, CRNH-IdF, CINFO, Bondy, France.
P
P
Valensi
Scientific and Medical Affairs, Novartis Pharma, Rueil Malmaison, France. Electronic address: beatrice.fiquet@novartis.com.
B
B
Fiquet
Endocrinology and Metabolism Department, Pitié Salpétrière Hospital, Paris, France.
S
S
Dejager
Endocrinology and Metabolism Department, CHU Nantes, France.
B
B
Charbonnel
D000218:Adamantane / Q000031:analogs & derivatives / Q000627:therapeutic use; D000368:Aged; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use; D010865:Pilot Projects; D011759:Pyrrolidines / Q000627:therapeutic use; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D000077597:Vildagliptin
D000218:Adamantane; D001786:Blood Glucose; D054873:Dipeptidyl-Peptidase IV Inhibitors; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D009570:Nitriles; D011759:Pyrrolidines; D013453:Sulfonylurea Compounds; D000077597:Vildagliptin
Basal insulin initiation; Clinical trial; DPP4 inhibitors; Hypoglycemia; Insulin secretagogues