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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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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/72900

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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