title: Cross-Over Study Comparing Postprandial Glycemic Increase After Addition of a Fixed-Dose Mitiglinide/Voglibose Combination or a Dipeptidyl Peptidase-4 Inhibitor to Basal Insulin Therapy in Patients with Type 2 Diabetes Mellitus.
abstract: BACKGROUND Although the efficacy of combination therapy consisting of basal insulin and oral hypoglycemic agents (OHAs) has been shown, which OHAs are the most efficient remains unclear. MATERIAL AND METHODS Five patients with type 2 diabetes were enrolled and treated with insulin degludec and metformin as a basal therapy. The patients were randomized in a cross-over fashion to receive a combination of mitiglinide (10 mg) and voglibose (0.2 mg) (M+V) 3 times daily or linagliptin (5 mg) (L) once daily for 8 weeks. After 8 weeks, 2 kinds of meal tolerance tests were performed as breakfast on 2 consecutive days. The first breakfast contained 460 kcal (carbohydrates, 49.1%; protein, 15.7%; fat, 35.2%), while the second contained 462 kcal (carbohydrates, 37.2%; protein, 19.6%; fat, 43.2%). Self-monitoring blood glucose levels were measured at 0, 30, 60, and 120 min after the meal tests, and the increase in the postprandial area under the curve (AUC)0-120 min was determined. The HbA1c, glycated albumin, and 1,5-anhydroglucitol (AG) levels were measured, and continuous glucose monitoring was performed. RESULTS The increase in the postprandial AUC0-120 min was significantly smaller in the M+V group than in the L group after both meals. The 24-h average, 24-h standard deviations, 24-h AUC, and mean amplitude of glycemic excursion (MAGE) were similar for both groups and after both meals. The change in 1,5-AG was higher in the M+V group than in the L group. CONCLUSIONS The combination of M+V with basal therapy improved postprandial glucose excursion more effectively than L in T2DM patients.
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Center Hospital, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Ihana-Sugiyama
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Center Hospital, Tokyo, Japan.|Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan.
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Yamamoto-Honda
authors.affiliation: Department of Clinical Study and Informatics, Center for Clinical Sciences National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Sugiyama
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Center Hospital, Tokyo, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Tsujimoto
authors.affiliation: Saitama Citizens Medical Center, Saitama, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kakei
authors.affiliation: Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Noda
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D004152:Dipeptidyl-Peptidases and Tripeptidyl-Peptidases / Q000008:administration & dosage*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007294:Inositol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007328:Insulin / Q000097:blood; D049528:Insulin, Long-Acting / Q000008:administration & dosage; D054833:Isoindoles / Q000008:administration & dosage*; D000069476:Linagliptin / Q000008:administration & dosage; D008297:Male; D008687:Metformin / Q000008:administration & dosage; D008875:Middle Aged; D019518:Postprandial Period / Q000187:drug effects
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D054833:Isoindoles; D000069476:Linagliptin; D007294:Inositol; C571886:insulin degludec; D008687:Metformin; C087255:mitiglinide; D004152:Dipeptidyl-Peptidases and Tripeptidyl-Peptidases; C102817:voglibose