TITLE:
Clinical Characteristics of Japanese Type 2 Diabetic Patients Responsive to Sitagliptin
AUTHORS:
Kouichi Inukai, Takumi Hirata, Takashi Sumita, Masaki Watanabe, Yuichi Ikegami, Daisuke Ito, Susumu Kurihara, Nobuyuki Yasukawa, Jiro Morimoto, Nobuki Takata, Kenta Kanazawa, Tamotsu Neda, Yoshikazu Sumitani, Kiyoaki Inoue, Yuichi Noguchi, Toshio Hosaka, Hitoshi Ishida, Shigehiro Katayama
KEYWORDS:
Sitagliptin, Type 2 Diabetes, DPP-4 Inhibitors
JOURNAL NAME:
Journal of Diabetes Mellitus,
Vol.4 No.3,
July
31,
2014
ABSTRACT: Japanese type 2 diabetic
patients were treated with sitagliptin to evaluate the efficacy of this agent,
and also to investigate the clinical characteristics of those who responded to
sitagliptin. In total, 1001 diabetic patients, inadequately controlled (HbA1c ≥
6.5%) with oral hypoglycemic agents (OHA) other than DPP-4 inhibitors or with
diet and exercise only, were enrolled. We added 50mg of sitagliptin to the
therapeutic regimens of 410 patients including 68 OHA naive patients, while the
other 591 patients were switched from a single OHA to 50 mg of sitagliptin.
After 6 months, glycemic control was significantly improved due to both reduced
insulin resistance, as demonstrated by a significant HOMA-R reduction, and
recovery of pancreatic β cell function, as assessed by HOMA-β and the proinsulin/insulin (PI/I)
ratio. In the bivariable analysis, a good response, defined as an HbA1c
reduction during the 6 months of at least 0.9%, was associated with high HbA1c
and PI/I at baseline and combination treatments with sulfonylurea, biguanide
and α-glucosidase
inhibitors, but not with obesity. On the other hand, in the multivariable
regression analysis, only high baseline HbA1c and combination treatment with anα-glucosidase
inhibitor were significantly associated with a good response to sitagliptin. In
patients with type 2 diabetes, the addition of sitagliptin or switching from
another OHA to this agent achieved an HbA1c reduction without overloading β cells.
In particular, we suggest that a good response to sitagliptin can be expected
when this agent is combined with an α-glucosidase
inhibitor (UMIN No. #000014157).