Title: | Should sulfonylurea be discontinued or maintained at the lowest dose when starting ipragliflozin? A multicenter observational study in Japanese patients with type 2 diabetes |
Authors: | Takahashi, Kiyohiko Browse this author |
Cho, Kyu Yong Browse this author |
Nakamura, Akinobu Browse this author →KAKEN DB |
Miya, Aika Browse this author |
Miyoshi, Arina Browse this author |
Yamamoto, Chiho Browse this author |
Nomoto, Hiroshi Browse this author |
Niwa, Hirokatsu Browse this author |
Takahashi, Kiyohito Browse this author |
Manda, Naoki Browse this author |
Kurihara, Yoshio Browse this author |
Aoki, Shin Browse this author |
Ito, Yoichi M Browse this author →KAKEN DB |
Atsumi, Tatsuya Browse this author →KAKEN DB |
Miyoshi, Hideaki Browse this author →KAKEN DB |
Keywords: | Glycated hemoglobin |
Sodium-glucose cotransporter 2 inhibitor |
Sulfonylurea |
Issue Date: | Mar-2019 |
Publisher: | Wiley |
Journal Title: | Journal of Diabetes Investigation |
Volume: | 10 |
Issue: | 2 |
Start Page: | 429 |
End Page: | 438 |
Publisher DOI: | 10.1111/jdi.12913 |
PMID: | 30136403 |
Abstract: | Aims/Introduction: We investigated the difference in efficacy and safety between discontinuation and maintaining of sulfonylurea when adding a sodium-glucose cotransporter 2 inhibitor. Materials and Methods: In the present multicenter, prospective observational study, 200 patients with type 2 diabetes treated with sulfonylurea and with a need to add ipragliflozin were enrolled and divided into two groups: discontinued sulfonylurea (Discontinuation group) or maintained sulfonylurea, but at the lowest dose (Low-dose group) when adding ipragliflozin. We compared the two groups after 24 weeks using propensity score matching to adjust for differences between the groups. Results: In the matched cohort (58 patients in each group), baseline characteristics of both groups were balanced. The primary outcome of the proportion of patients with non-exacerbation in glycated hemoglobin after 24 weeks was 91.4% in the Low-dose group and 75.9% in the Discontinuation group, a significant difference (P = 0.024). However, bodyweight was significantly decreased in the Discontinuation group compared with the Low-dose group (-4.4 ± 2.1 kg vs -2.9 ± 1.9 kg, P < 0.01). Similarly, liver enzyme improvement was more predominant in the Discontinuation group. A logistic regression analysis showed that high-density lipoprotein cholesterol, age and sulfonylurea dose were independent factors associated with non-exacerbation of glycated hemoglobin in the Discontinuation group. Conclusions: The purpose of using ipragliflozin should be considered when making the decision to discontinue or maintain sulfonylurea at the lowest dose. Furthermore, low high-density lipoprotein cholesterol level, low dose of sulfonylurea and younger age were possible markers to not show worsening of glycemic control by discontinuing sulfonylurea. |
Rights: | http://creativecommons.org/licenses/by-nc/4.0/ |
Type: | article |
URI: | http://hdl.handle.net/2115/72899 |
Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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