Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Diabetes Metab J. 2011 Aug;35(4):411-7. doi: 10.4093/dmj.2011.35.4.411. Epub 2011 Aug 31.
To evaluate the clinical efficacy of sitagliptin for reducing plasma glucose levels in Korean subjects with type 2 diabetes mellitus during a 14-week treatment period.
Our study design involved the addition of 100 mg sitagliptin once-daily to three ongoing combination therapy regimens and changing from glimepiride and metformin to sitagliptin and metformin.
The addition of sitagliptin 100 mg/day produced a statistically significant reduction in mean HbA1c level (mean HbA1c reduction of 0.99±0.85%, P<0.01). In the group taking a combination of sitagliptin and metformin (n=143, initial mean HbA1c level=7.48%), the reductions in HbA1c, 2-hour postprandial glucose, and fasting glucose levels were 0.72±0.76% (P<0.01), 47±65 mg/dL (P<0.01), and 15±44 mg/dL (P<0.01), respectively. In the group taking a combination of sitagliptin, glimepiride, and metformin (n=125, initial mean HbA1c level=8.42%), the reductions in HbA1c, 2-hour postprandial glucose, and fasting glucose levels were 1.09±0.86% (P<0.01), 62±64 mg/dL (P<0.01), and 31±45 mg/dL (P<0.01), respectively. In the group taking a combination of sitagliptin, glimepiride, metformin, and α-glucosidase inhibitor (n=63, initial mean HbA1c level=9.19%), the reductions in HbA1c, 2-hour postprandial glucose, and fasting glucose levels were 1.27±0.70% (P<0.01), 72±65 mg/dL (P<0.01), and 35±51 mg/dL (P<0.01), respectively. In the group that had previous hypoglycemic events and that changed from glimepiride to sitagliptin, HbA1c level did not change but fasting glucose increased significantly (14±29 mg/dL, P<0.01).
Sitagliptin combination therapy for 14 weeks significantly improved glycemic control and was well-tolerated in Korean subjects with type 2 diabetes mellitus.
评估西他列汀在韩国 2 型糖尿病患者中降低血糖水平的临床疗效,为期 14 周的治疗期。
我们的研究设计包括在三种正在进行的联合治疗方案中添加 100 毫克西他列汀,并将格列美脲和二甲双胍改为西他列汀和二甲双胍。
每天添加 100 毫克西他列汀可使平均 HbA1c 水平显著降低(平均 HbA1c 降低 0.99±0.85%,P<0.01)。在服用西他列汀和二甲双胍联合治疗的组(n=143,初始平均 HbA1c 水平=7.48%)中,HbA1c、餐后 2 小时血糖和空腹血糖水平分别降低 0.72±0.76%(P<0.01)、47±65mg/dL(P<0.01)和 15±44mg/dL(P<0.01)。在服用西他列汀、格列美脲和二甲双胍联合治疗的组(n=125,初始平均 HbA1c 水平=8.42%)中,HbA1c、餐后 2 小时血糖和空腹血糖水平分别降低 1.09±0.86%(P<0.01)、62±64mg/dL(P<0.01)和 31±45mg/dL(P<0.01)。在服用西他列汀、格列美脲、二甲双胍和α-葡萄糖苷酶抑制剂联合治疗的组(n=63,初始平均 HbA1c 水平=9.19%)中,HbA1c、餐后 2 小时血糖和空腹血糖水平分别降低 1.27±0.70%(P<0.01)、72±65mg/dL(P<0.01)和 35±51mg/dL(P<0.01)。在有低血糖事件且从格列美脲改为西他列汀的组中,HbA1c 水平没有变化,但空腹血糖显著升高(14±29mg/dL,P<0.01)。
西他列汀联合治疗 14 周可显著改善血糖控制,且在韩国 2 型糖尿病患者中具有良好的耐受性。