2024-03-29T09:14:59Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/729002022-11-17T02:08:08Zhdl_2115_20040hdl_2115_121Reduction in glucose fluctuations in elderly patients with type 2 diabetes using repaglinide : A randomized controlled trial of repaglinide vs sulfonylureaOmori, KazunoNomoto, HiroshiNakamura, AkinobuTakase, TakahiroCho, Kyu YongOno, KotaManda, NaokiKurihara, YoshioAoki, ShinAtsumi, TatsuyaMiyoshi, HideakiElderlyGlucose variabilityRepaglinide490Aims/Introduction: Glinides are antidiabetic drugs that enhance the early phase of insulin secretion, but have been considered to be less effective at lowering blood glucose than sulfonylureas. However, glinides show a lower risk of hypoglycemia and a greater effect on postprandial hyperglycemia, and are particularly recommended for use in elderly patients with type 2 diabetes. We investigated the efficacy and safety of repaglinide compared with sulfonylurea for the treatment of elderly patients. Materials and Methods: In the present multicenter, prospective, randomized, open-label, controlled trial, 57 elderly lean patients with type 2 diabetes who were being treated with sulfonylureas were studied. They were either switched to repaglinide (Repa group) or continued a sulfonylurea (SU group) for 12 weeks. The primary outcome comprised the change in glycemic control, and among the secondary outcomes was the presence of hypoglycemia and drug compliance. Results: Although glycated hemoglobin (HbA1c) was not significantly different between the two groups (SU +0.02% vs Repa -0.07%), greater improvements in the glycated albumin (GA) and GA to HbA1c ratio (GA/HbA1c) were observed in the Repa group (ΔGA, SU +0.12% vs Repa -1.15%; ΔGA/HbA1c, SU +0.01 vs Repa -0.13; each P < 0.01) without increasing hypoglycemia. When the Repa group was subdivided according to whether GA improved, the SU dose before switching to repaglinide was significantly smaller and the homeostatic model assessment of β-cell function was significantly higher in the GA improvement subgroup. Conclusions: Switching from SU to Repa improved GA and GA/HbA1c, and had favorable effects on glucose fluctuation in elderly patients with type 2 diabetes.WileyJournal Articleapplication/pdfimage/tiffapplication/vnd.openxmlformats-officedocument.wordprocessingml.documenthttp://hdl.handle.net/2115/72900https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/72900/5/Omori_et_al-2019-Journal_of_Diabetes_Investigation.pdfhttps://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/72900/4/jdi12889-sup-0001-figs1.tifhttps://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/72900/3/jdi12889-sup-0002-tables1-3.docx2040-1116Journal of Diabetes Investigation1023673742019-03enginfo:doi/10.1111/jdi.12889http://creativecommons.org/licenses/by-nc/4.0/publisher