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Sitagliptin improves glycaemic excursion after a meal or after an oral glucose load in J apanese subjects with impaired glucose tolerance
Author(s) -
Kaku K.,
Kadowaki T.,
Terauchi Y.,
Okamoto T.,
Sato A.,
Okuyama K.,
Arjona Ferreira J. C.,
Goldstein B. J.
Publication year - 2015
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12507
Subject(s) - sitagliptin , medicine , endocrinology , placebo , sitagliptin phosphate , impaired glucose tolerance , insulin , dipeptidyl peptidase 4 inhibitor , area under the curve , meal , tolerability , type 2 diabetes , diabetes mellitus , adverse effect , insulin resistance , metformin , alternative medicine , pathology
Aims To evaluate the efficacy and tolerability of sitagliptin in subjects with impaired glucose tolerance ( IGT ). Methods In a double‐blind, parallel‐group study, 242 Japanese subjects with IGT , determined by a 75‐g oral glucose tolerance test ( OGTT ) at week −1, were randomized (1 : 1 : 1) to placebo (n = 83), sitagliptin 25 mg (n = 82) or 50 mg (n = 77) once daily for 8 weeks. Glycaemic variables were assessed using another OGTT at week 7 and meal tolerance tests ( MTTs ) at weeks 0 and 8. Primary and secondary endpoints were percent change from baseline in glucose total area under the curve 0–2 h ( AUC 0 –2 h ) during the MTT and OGTT , respectively. Results Least squares mean percent change from baseline in glucose AUC 0 –2 h during the MTT were −2.4, −9.5 and −11.5%, and during the OGTT were −3.7, −21.4 and −20.1% with placebo, sitagliptin 25 mg once daily, and 50 mg once daily, respectively (p < 0.001 for either sitagliptin dose vs placebo in both tests). Sitagliptin treatment enhanced early insulin response during the OGTT and decreased total insulin response, assessed as the total AUC 0 –2 h during the MTT . Sitagliptin treatment also suppressed glucagon response during the MTT . The incidence of adverse events, including hypoglycaemia, was low and generally similar in all treatment groups. Conclusions Treatment with sitagliptin significantly reduced glucose excursions during both an MTT and an OGTT ; this effect was associated with an increase in early insulin secretion after oral glucose loading as well as a blunted glucagon response during an MTT . Sitagliptin was generally well tolerated in subjects with IGT .