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 .
A comparative study of the effects of a dipeptidyl peptidase-IV inhibitor and sulfonylurea on glucose variability in patients with type 2 diabetes with inadequate glycemic control on metformin.
BACKGROUND This study aim ed to compare the effects of sitagliptin on glycemic change and 24-h blood glucose variability with those of the sulfonylurea glimepiride . SUBJECTS AND METHODS A 4-week r and omized double blind-labeled prospect i ve design was used . We recruited 33 patients who had been treated with metformin for at least 2 months . Each participant prescribed with metformin was r and omly assigned to either the sitagliptin ( 100 mg ) or the glimepiride ( 2 mg ) group .  Continuous glucose monitoring ( CGM ) was used to monitor glycemic changes for 3 successive days in both groups at baseline and at the 4-week follow-up . Glycemic changes and glucose variability were obtained using CGM , and these data were averaged over all subjects . RESULTS The comparison of glycated hemoglobin ( HbA1c ) between baseline and the 4-week follow-up showed that HbA1c was significantly reduced in the sitagliptin group ( 7.0 ± 0.5 % to 6.6 ± 0.4 % , P<0.001 ) and the glimepiride group ( 7.3 ± 0.4 % to 6.9 ± 0.4 % , P<0.001 ) . The sitagliptin and glimepiride groups had similar HbA1c levels after 4 weeks , and there were no significant differences between the two groups . The mean amplitude of glycemic excursions ( MAGE ) decreased significantly in the sitagliptin group ( 4.9 ± 1.0 to 3.7 ± 0.9 mmol/L , P<0.001 ) , but no significant difference was observed in the glimepiride group ( 5.7 ± 1.5 to 5.0 ± 1.4 mmol/L , P=0.175 ) . The SD and oxidative stress markers did not differ significantly between the two groups . CONCLUSIONS When sitagliptin was combined with metformin , the patients showed much more efficient blood glucose controlling effects , not only the three indexes of fasting blood glucose , postpr and ial blood glucose , and glycated hemoglobin , but also MAGE
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 .