title: Adding of Sitagliptin on Insulin Therapy Effectively and Safely Reduces a Hemoglobin A1c Level and Glucose Fluctuation in Japanese Patients with Type 2 Diabetes.
abstract: Aims. Efficacy and safety of DPP-4 inhibitor, sitagliptin, add-on therapy to insulin were investigated in Japanese patients with type 2 diabetes. Subjects and Methods. Two hundred and sixteen patients (126 men, 65 ± 12 years old, BMI 24.9 ± 4.5, means ± S.D.) who had been treated by insulin alone or insulin combined with other oral hypoglycemic agents (OHAs) were recruited, and sitagliptin was added for 3 months. Results. HbA1c was significantly decreased after 3 months of add-on therapy as a whole (8.56 ± 1.50% to 7.88 ± 1.25%, P < 0.0001). Body weight did not change and insulin dosage was significantly (P < 0.0001) decreased for 3 months. Furthermore, day-to-day glucose variability was significantly reduced (18.3 ± 9.1 to 16.1 ± 8.1%, P < 0.05). In stepwise multiple regression analysis on ΔHbA1c as an outcome variable, the higher baseline HbA1c value and a preserved CPR were selected as significant predictive variables. Fifteen patients complained of mild hypoglycemia without any assistance during 3 months of sitagliptin add-on, while no severe hypoglycemic episode was reported. Conclusions. Add-on of sitagliptin to ongoing insulin therapy effectively reduced either HbA1c level or glucose fluctuation and could be a practical and well-tolerated alternative to treat Japanese patients with type 2 diabetes who had been inadequately controlled by insulin with or without other OHAs.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tajiri
authors.affiliation: Municipal Yame General Hospital, Yame 834-0034, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Kawano
authors.affiliation: Municipal Yame General Hospital, Yame 834-0034, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Hirao
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan.
authors.forename: Tamami
authors.initials: T
authors.lastname: Oshige
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan.
authors.forename: Shinpei
authors.initials: S
authors.lastname: Iwata
authors.affiliation: Kouhoukai Takagi Hospital, Okawa 831-0016, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Inada Clinic, Kurume 830-0039, Japan.
authors.forename: Chizuko
authors.initials: C
authors.lastname: Inada
authors.affiliation: Shimada Hospital, Ogori 838-0141, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akashi
authors.affiliation: Tenjinkai Koga Hospital 21, Kurume 839-0801, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Saint Mary Hospital, Kurume 830-8543, Japan.
authors.forename: Yuichi
authors.identifier: 0000-0002-1472-3758
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Tenjinkai Shin-Koga Hospital, Kurume 830-8577, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tojikubo
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamada