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Comparison of the efficacy of sitagliptin and glimepiride dose-up in Japanese patients with type 2 diabetes poorly controlled by sitagliptin and glimepiride in combination.

Shimoda S, Iwashita S, Sekigami T, Furukawa N, Matsuo Y, Ichimori S, Goto R, Maeda T, Watanabe E, Kondo T, Matsumura T, Motoshima H, Nishida K, Araki E - J Diabetes Investig (2013)

Bottom Line: Univariate linear regression analyses showed that the percentage change in HbA1c was significantly associated with the serum level of arachidonic acid (AA) in both groups.There was no significant difference in the HbA1c-lowering effects between the two groups.However, a significant HbA1c-lowering effect from baseline of glimepiride dose-up was found, and the AA level showed a negative correlation with the decrease in HbA1c in the sitagliptin dose-up group, but a positive correlation in the glimepiride dose-up group.

View Article: PubMed Central - PubMed

Affiliation: Department of Metabolic Medicine Faculty of Life Sciences Kumamoto University Kumamoto Japan.

ABSTRACT

Aims/introduction: The goal of the study was to examine the effects of sitagliptin dose-up or glimepiride dose-up in Japanese patients with type 2 diabetes who were controlled inadequately by sitagliptin and glimepiride in combination.

Materials and methods: A multicenter, prospective, randomized, open-label study was carried out in 50 patients with type 2 diabetes treated with sitagliptin and low-dose glimepiride. The patients were randomly assigned to receive the addition of 50 mg/day sitagliptin or 0.5 mg/day glimepiride. The primary end-point was the percentage change in glycated hemoglobin (HbA1c).

Results: During a follow-up period, the difference in the percentage changes in HbA1c between the two groups was not significant (P = 0.13). However, HbA1c was significantly decreased by glimepiride dose-up (P < 0.01 vs baseline), but not by sitagliptin dose-up (P = 0.74). Univariate linear regression analyses showed that the percentage change in HbA1c was significantly associated with the serum level of arachidonic acid (AA) in both groups.

Conclusions: There was no significant difference in the HbA1c-lowering effects between the two groups. However, a significant HbA1c-lowering effect from baseline of glimepiride dose-up was found, and the AA level showed a negative correlation with the decrease in HbA1c in the sitagliptin dose-up group, but a positive correlation in the glimepiride dose-up group. These findings suggest that the AA level is associated with HbA1c reduction in response to dose-up with these drugs in patients with type 2 diabetes in a combination therapy with sitagliptin and glimepiride. This trial was registered with UMIN (no. 000009544).

No MeSH data available.


Related in: MedlinePlus

(a) Correlations between the percentage changes in glycated hemoglobin (HbA1c) and serum levels of arachidonic acid (AA) at baseline with 50 mg/day of sitagliptin dose‐up (closed circles, dotted line) and 0.5 mg/day of glimepiride dose‐up (open circles, solid line). (b) Comparison of the percentage changes in glycated hemoglobin (HbA1c) with between 50 mg/day of sitagliptin dose‐up (black bars) and 0.5 mg/day of glimepiride dose‐up (white bars), when the patients in each group were divided into two subgroups by average level of AA.
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jdi12151-fig-0002: (a) Correlations between the percentage changes in glycated hemoglobin (HbA1c) and serum levels of arachidonic acid (AA) at baseline with 50 mg/day of sitagliptin dose‐up (closed circles, dotted line) and 0.5 mg/day of glimepiride dose‐up (open circles, solid line). (b) Comparison of the percentage changes in glycated hemoglobin (HbA1c) with between 50 mg/day of sitagliptin dose‐up (black bars) and 0.5 mg/day of glimepiride dose‐up (white bars), when the patients in each group were divided into two subgroups by average level of AA.

Mentions: Correlations of AA, EPA, DHA and EPA/AA ratio with the percentage change in HbA1c determined by linear regression analysis are shown in Table 3. Simple linear regression analysis showed that baseline AA and the percentage change in HbA1c were negatively correlated in the sitagliptin dose‐up group (r = −0.497, P < 0.05), but positively correlated in the glimepiride dose‐up group (r = 0.531, P < 0.01; Figure 2a). To further investigate the impact of AA on the efficacy of the two treatments, the participants in each group were divided into two subgroups by average level of AA (196.9 μg/mL), and percentage change in HbA1c in these subgroups was analyzed. In patients with AA ≤196.9 μg/mL, the percentage change in HbA1c in the glimepiride dose‐up group (−5.2 ± 5.6%) significantly decreased more than that in the sitagliptin dose‐up group (0.3 ± 4.6%; P < 0.01). In contrast, in patients with AA >196.9 μg/mL, the percentage change in HbA1c in the sitagliptin dose‐up group (−3.9 ± 3.1%) significantly decreased more than that in the glimepiride dose‐up group (0.13 ± 2.9%, P < 0.01; Figure 2b).


Comparison of the efficacy of sitagliptin and glimepiride dose-up in Japanese patients with type 2 diabetes poorly controlled by sitagliptin and glimepiride in combination.

Shimoda S, Iwashita S, Sekigami T, Furukawa N, Matsuo Y, Ichimori S, Goto R, Maeda T, Watanabe E, Kondo T, Matsumura T, Motoshima H, Nishida K, Araki E - J Diabetes Investig (2013)

(a) Correlations between the percentage changes in glycated hemoglobin (HbA1c) and serum levels of arachidonic acid (AA) at baseline with 50 mg/day of sitagliptin dose‐up (closed circles, dotted line) and 0.5 mg/day of glimepiride dose‐up (open circles, solid line). (b) Comparison of the percentage changes in glycated hemoglobin (HbA1c) with between 50 mg/day of sitagliptin dose‐up (black bars) and 0.5 mg/day of glimepiride dose‐up (white bars), when the patients in each group were divided into two subgroups by average level of AA.
© Copyright Policy - creativeCommonsBy-nc-nd
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4020337&req=5

jdi12151-fig-0002: (a) Correlations between the percentage changes in glycated hemoglobin (HbA1c) and serum levels of arachidonic acid (AA) at baseline with 50 mg/day of sitagliptin dose‐up (closed circles, dotted line) and 0.5 mg/day of glimepiride dose‐up (open circles, solid line). (b) Comparison of the percentage changes in glycated hemoglobin (HbA1c) with between 50 mg/day of sitagliptin dose‐up (black bars) and 0.5 mg/day of glimepiride dose‐up (white bars), when the patients in each group were divided into two subgroups by average level of AA.
Mentions: Correlations of AA, EPA, DHA and EPA/AA ratio with the percentage change in HbA1c determined by linear regression analysis are shown in Table 3. Simple linear regression analysis showed that baseline AA and the percentage change in HbA1c were negatively correlated in the sitagliptin dose‐up group (r = −0.497, P < 0.05), but positively correlated in the glimepiride dose‐up group (r = 0.531, P < 0.01; Figure 2a). To further investigate the impact of AA on the efficacy of the two treatments, the participants in each group were divided into two subgroups by average level of AA (196.9 μg/mL), and percentage change in HbA1c in these subgroups was analyzed. In patients with AA ≤196.9 μg/mL, the percentage change in HbA1c in the glimepiride dose‐up group (−5.2 ± 5.6%) significantly decreased more than that in the sitagliptin dose‐up group (0.3 ± 4.6%; P < 0.01). In contrast, in patients with AA >196.9 μg/mL, the percentage change in HbA1c in the sitagliptin dose‐up group (−3.9 ± 3.1%) significantly decreased more than that in the glimepiride dose‐up group (0.13 ± 2.9%, P < 0.01; Figure 2b).

Bottom Line: Univariate linear regression analyses showed that the percentage change in HbA1c was significantly associated with the serum level of arachidonic acid (AA) in both groups.There was no significant difference in the HbA1c-lowering effects between the two groups.However, a significant HbA1c-lowering effect from baseline of glimepiride dose-up was found, and the AA level showed a negative correlation with the decrease in HbA1c in the sitagliptin dose-up group, but a positive correlation in the glimepiride dose-up group.

View Article: PubMed Central - PubMed

Affiliation: Department of Metabolic Medicine Faculty of Life Sciences Kumamoto University Kumamoto Japan.

ABSTRACT

Aims/introduction: The goal of the study was to examine the effects of sitagliptin dose-up or glimepiride dose-up in Japanese patients with type 2 diabetes who were controlled inadequately by sitagliptin and glimepiride in combination.

Materials and methods: A multicenter, prospective, randomized, open-label study was carried out in 50 patients with type 2 diabetes treated with sitagliptin and low-dose glimepiride. The patients were randomly assigned to receive the addition of 50 mg/day sitagliptin or 0.5 mg/day glimepiride. The primary end-point was the percentage change in glycated hemoglobin (HbA1c).

Results: During a follow-up period, the difference in the percentage changes in HbA1c between the two groups was not significant (P = 0.13). However, HbA1c was significantly decreased by glimepiride dose-up (P < 0.01 vs baseline), but not by sitagliptin dose-up (P = 0.74). Univariate linear regression analyses showed that the percentage change in HbA1c was significantly associated with the serum level of arachidonic acid (AA) in both groups.

Conclusions: There was no significant difference in the HbA1c-lowering effects between the two groups. However, a significant HbA1c-lowering effect from baseline of glimepiride dose-up was found, and the AA level showed a negative correlation with the decrease in HbA1c in the sitagliptin dose-up group, but a positive correlation in the glimepiride dose-up group. These findings suggest that the AA level is associated with HbA1c reduction in response to dose-up with these drugs in patients with type 2 diabetes in a combination therapy with sitagliptin and glimepiride. This trial was registered with UMIN (no. 000009544).

No MeSH data available.


Related in: MedlinePlus