Open AccessComparison of the efficacy of sitagliptin and glimepiride dose‐up in J apanese patients with type 2 diabetes poorly controlled by sitagliptin and glimepiride in combination
Author(s) -
Shimoda Seiya,
Iwashita Shinsuke,
Sekigami Taiji,
Furukawa Noboru,
Matsuo Yasuto,
Ichimori Shinji,
Goto Rieko,
Maeda Takako,
Watanabe Eiichiro,
Kondo Tatsuya,
Matsumura Takeshi,
Motoshima Hiroyuki,
Nishida Kenro,
Araki Eiichi
Publication year - 2014
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12151
Subject(s) - glimepiride , sitagliptin , medicine , type 2 diabetes , glycated hemoglobin , sitagliptin phosphate , dipeptidyl peptidase 4 inhibitor , diabetes mellitus , hypoglycemia , gastroenterology , pharmacology , endocrinology , urology
Abstract Aims/Introduction The goal of the study was to examine the effects of sitagliptin dose‐up or glimepiride dose‐up in J apanese 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 ( H b A 1c). Results During a follow‐up period, the difference in the percentage changes in H b A 1c between the two groups was not significant ( P = 0.13). However, H b A 1c 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 H b A 1c was significantly associated with the serum level of arachidonic acid ( AA ) in both groups. Conclusions There was no significant difference in the H b A 1c‐lowering effects between the two groups. However, a significant H b A 1c‐lowering effect from baseline of glimepiride dose‐up was found, and the AA level showed a negative correlation with the decrease in H b A 1c 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 H b A 1c 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. 9544).