Tomohiro Matsuhashi, Motoaki Sano, Keiichi Fukuda, Department of Cardiology, Keio University School of Medicine, Tokyo 160-8582, Japan.
World J Diabetes. 2012 Jun 15;3(6):118-22. doi: 10.4239/wjd.v3.i6.118.
To assess the effect of sitagliptin therapy on seasonal fluctuation of glycemic control in Japanese type 2 diabetic patients.
Participating patients (age: 29-80 years) had been treated with conventional oral antidiabetic agents and/or diet and exercise therapy for over 6 mo. From December 2009, 35 patients were additionally prescribed oral sitagliptin starting from 50 mg once daily, while 19 patients taking α-glucosidase inhibitors were switched to sitagliptin. Twenty-four patients who refused sitagliptin formed the control group. Changes of mean monthly hemoglobin A(1c) (HbA(1c)) during the "winter holiday season" were compared between groups using Student's t-test (2008-2009 vs 2009-2010). Statistical significance was accepted at P < 0.05. Multivariate analysis was performed to assess whether sitagliptin use was associated with deterioration or improvement of glycemic control.
Both add-on sitagliptin and switching from α-glucosidase inhibitors to sitagliptin prevented the seasonal deterioration of glycemic control and tended to improve HbA(1c). Multivariate analysis revealed that both adding and switching to sitagliptin were negatively correlated with deterioration of glycemic control. In 44 patients who continued sitagliptin therapy for another year, elevation of HbA(1c) was suppressed without adverse effects.
Sitagliptin is a suitable oral agent for preventing deterioration of glycemic control during the winter holiday season.
评估西他列汀治疗对日本 2 型糖尿病患者血糖控制季节性波动的影响。
参与患者（年龄：29-80 岁）已接受常规口服降糖药和/或饮食及运动疗法治疗超过 6 个月。自 2009 年 12 月起，35 例患者加用口服西他列汀，起始剂量为 50mg，每日 1 次，19 例服用α-葡萄糖苷酶抑制剂的患者换用西他列汀。24 例拒绝西他列汀的患者为对照组。采用学生 t 检验比较各组“冬季度假季节”期间平均每月糖化血红蛋白（HbA1c）的变化（2008-2009 年与 2009-2010 年）。P<0.05 为差异有统计学意义。采用多变量分析评估西他列汀的使用是否与血糖控制恶化或改善相关。
加用西他列汀和从α-葡萄糖苷酶抑制剂换用西他列汀均可防止血糖控制的季节性恶化，并倾向于改善 HbA1c。多变量分析显示，加用和换用西他列汀均与血糖控制恶化呈负相关。在另外 44 例继续西他列汀治疗 1 年的患者中，HbA1c 的升高得到抑制，且无不良反应。
西他列汀是预防冬季度假季节血糖控制恶化的合适口服药物。
