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A randomized controlled trial comparing the effects of dapagliflozin and DPP-4 inhibitors on glucose variability and metabolic parameters in patients with type 2 diabetes mellitus on insulin
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| Title: | A randomized controlled trial comparing the effects of dapagliflozin and DPP-4 inhibitors on glucose variability and metabolic parameters in patients with type 2 diabetes mellitus on insulin |
| Authors: | Nomoto, Hiroshi Browse this author | | Miyoshi, Hideaki Browse this author →KAKEN DB | | Sugawara, Hajime Browse this author | | Ono, Kota Browse this author | | Yanagiya, Shingo Browse this author | | Oita, Mayuko Browse this author | | Nakamura, Akinobu Browse this author →KAKEN DB | | Atsumi, Tatsuya Browse this author →KAKEN DB |
| Keywords: | Blood glucose fluctuation | | Dipeptidyl peptidase-4 inhibitors | | Sodium-glucose co-transporter 2 inhibitors | | Type 2 diabetes mellitus |
| Issue Date: | 17-Jul-2017 |
| Publisher: | BioMed Central |
| Journal Title: | Diabetology & Metabolic Syndrome |
| Volume: | 9 |
| Start Page: | 54 |
| Publisher DOI: | 10.1186/s13098-017-0255-8 |
| Abstract: | Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose co-transporter 2 (SGLT2) inhibitors improve hyperglycemia, and the usefulness of co-administration of DPP-4 inhibitors and insulin therapy has been well established. However, it has been still uncertain whether combination therapy of SGLT2 inhibitors and insulin is superior to that of DPP-4 inhibitors and the latter. Therefore, we investigated the superiority of dapagliflozin on glucose fluctuation compared with DPP-4 inhibitors in patients with type 2 diabetes mellitus (T2DM) on insulin using a continuous glucose monitoring (CGM) system. Methods: In this prospective, randomized, open-label controlled trial, 36 patients with T2DM and treated with DPP-4 inhibitors and insulin therapy, were enrolled and allocated into two groups. The patients either switched their DPP-4 inhibitors to dapagliflozin 5 mg for 12 weeks, or continued their DPP-4 inhibitors for the same period. CGM analyses and metabolic markers were assessed before and after treatment periods. Results: In total, data from 29 patients were analyzed. There were no significant differences in the mean amplitude of glycemic excursions and other CGM profiles in either group after treatment. Within the dapagliflozin treatment group, significant reductions of body mass index and albuminuria, and increases of HbA1c, hemoglobin and hematocrit were observed, but improvement of albuminuria was not significant if compared with the DPP-4 continuation group. Conclusions: Combination therapy of dapagliflozin and insulin was not superior in glucose fluctuation to DPP-4 inhibitors on insulin. However, dapagliflozin may in part provide favorable effects on metabolism in patients with T2DM treated with insulin therapy. |
| Rights: | http://creativecommons.org/licenses/by/4.0/ |
| Type: | article |
| URI: | http://hdl.handle.net/2115/67129 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 三好 秀明
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