Efficacy and safety of sitagliptin in Japanese patients with type 2 diabetes switched from glinides

Aims/IntroductionThe efficacy and safety of sitagliptin, a dipeptidyl peptidase (DPP)-4 inhibitor, were compared with those of glinides in Japanese patients with type2 diabetes. Materials and MethodsThe participants were 82 patients with type2 diabetes (glycated hemoglobin [HbA1c] 6.0% and <10%) under treatment with glinides for glucose control. The participants were randomly assigned to a group (n=44) receiving continuous treatment with glinides and a group (n=38) switched to sitagliptin. Patients were followed for 12weeks to evaluate glucose control. A meal tolerance test was carried out in weeks 0 and 12 to examine the pancreatic secretory response to postprandial hyperglycemia. ResultsThe changes in HbA1c from week 0 to week 12 were -0.25 and -0.05% in the sitagliptin and glinide groups, respectively, with a significant improvement with sitagliptin. The differences in fasting plasma glucose (FPG), glycoalbumin and 1,5-anhydroglucitol between the two groups were 14.2mg/dL, 0.7% and 1.7g/mL, respectively, showing significant improvements with sitagliptin. In the meal tolerance test, glucose at 0min was lower in the sitagliptin group; however, there were no differences in glucose elevation at 30 and 60min compared with 0min. Plasma insulin and glucagon secretion at week12 were significantly lower than at baseline in the sitagliptin group. Adverse events including hypoglycemia did not differ between the groups. ConclusionsFPG decreased and glucose control improved in patients who switched from glinides to sitagliptin. Sitagliptin decreased secretion of insulin and glucagon in a meal tolerance test compared with glinides, whereas the agents showed similar inhibition of postprandial hyperglycemia. This trial was registered with UMIN (UMIN-CTR no. 000003479).