Initial combination therapy with DPP-IV inhibitors more effectively reduced MAGE than stepwise add-on therapies ( p = 0.006 ) , although no differences in MAGE were found based on HbA1c values .
These findings indicate that DPP-IV inhibitors are promising alternatives for reducing GV in type 2 diabetes patients .
Glycemic variability ( GV ) has been an emerging target for preventing complications related to type 2 diabetes .
For reducing GV , DPP-IV inhibitors have shown effectiveness compared to other oral anti-hyperglycemic drugs ( OADs ) , but systematic evaluation has yet to be existed .
Effect of short‐term treatment with sitagliptin or glibenclamide on daily glucose fluctuation in drug‐naïve Japanese patients with type 2 diabetes mellitus
AIMS To compare the effect of a dipeptidyl peptidase-4 inhibitor ( DPP4-i ) and a sulfonylurea ( SU ) on daily glucose fluctuation in drug-naïve Japanese patients with type 2 diabetes mellitus ( T2DM ) . MATERIAL S AND METHODS A total of 53 drug-naïve Japanese patients with T2DM ( HbA1c , 7.0%-9.0 % ; fasting plasma glucose , 6.1 mmol/L or higher ) were r and omly assigned to either sitagliptin 50 mg qd or glibenclamide 2.5 mg per day ( given in divided doses ) in a 1:1 ratio . A continuous glucose monitoring ( CGM ) device was used to obtain 24-hour glucose profiles for each patient at baseline and at Week 2 . The primary study endpoint was change from baseline in mean amplitude of glucose excursion ( MAGE ) during a 24-hour period . A key secondary endpoint was change from baseline in the st and ard deviation ( SD ) of 24-hour glucose levels . RESULTS After 2 weeks of treatment , a numerically greater reduction in MAGE from baseline was observed in the sitagliptin group compared with the glibenclamide group , but the between-treatment difference was not statistically significant ( LS mean difference [ 95 % CI ] : -0.48 mmol/L [ -1.31 , 0.34 ] ; P = .245 ) . However , a significantly greater reduction in the change from baseline in SD was observed in the sitagliptin group compared with the glibenclamide group ( LS mean difference [ 95 % CI ] : -0.33 mmol/L [ -0.62 , -0.03 ] ; P = .029 ) . CONCLUSIONS This study suggests that the DPP4 inhibitor sitagliptin has a greater ability to reduce daily glucose fluctuation than the SU glibenclamide in drug-naïve Japanese patients with T2DM . Clinical Trials.gov : NCT02318693
Initial combination therapy with DPP-IV inhibitors more effectively reduced MAGE than stepwise add-on therapies ( p = 0.006 ) , although no differences in MAGE were found based on HbA1c values .
These findings indicate that DPP-IV inhibitors are promising alternatives for reducing GV in type 2 diabetes patients .
Glycemic variability ( GV ) has been an emerging target for preventing complications related to type 2 diabetes .
For reducing GV , DPP-IV inhibitors have shown effectiveness compared to other oral anti-hyperglycemic drugs ( OADs ) , but systematic evaluation has yet to be existed .