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Reduction in glucose fluctuations in elderly patients with type 2 diabetes using repaglinide : A randomized controlled trial of repaglinide vs sulfonylurea
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Title: | Reduction in glucose fluctuations in elderly patients with type 2 diabetes using repaglinide : A randomized controlled trial of repaglinide vs sulfonylurea |
Authors: | Omori, Kazuno Browse this author | Nomoto, Hiroshi Browse this author | Nakamura, Akinobu Browse this author →KAKEN DB | Takase, Takahiro Browse this author | Cho, Kyu Yong Browse this author | Ono, Kota Browse this author | Manda, Naoki Browse this author | Kurihara, Yoshio Browse this author | Aoki, Shin Browse this author | Atsumi, Tatsuya Browse this author →KAKEN DB | Miyoshi, Hideaki Browse this author →KAKEN DB |
Keywords: | Elderly | Glucose variability | Repaglinide |
Issue Date: | Mar-2019 |
Publisher: | Wiley |
Journal Title: | Journal of Diabetes Investigation |
Volume: | 10 |
Issue: | 2 |
Start Page: | 367 |
End Page: | 374 |
Publisher DOI: | 10.1111/jdi.12889 |
Abstract: | Aims/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. |
Rights: | http://creativecommons.org/licenses/by-nc/4.0/ |
Type: | article |
URI: | http://hdl.handle.net/2115/72900 |
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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Submitter: 三好 秀明
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