Tanaka Seiichi, Suzuki Kunihiro, Aoki Chie, Niitani Mai, Kato Kanako, Tomotsune Takanori, Aso Yoshimasa
Department of Endocrinology and Metabolism, Dokkyo Medical University , Tochigi, Japan .
Diabetes Technol Ther. 2014 Dec;16(12):840-5. doi: 10.1089/dia.2014.0095. Epub 2014 Aug 21.
This study investigated whether teneligliptin, a novel dipeptidyl peptidase-4 inhibitor, ameliorated glucose fluctuations in hospitalized Japanese patients with type 2 diabetes receiving insulin therapy, with or without other antidiabetes drugs, and using continuous glucose monitoring (CGM).
Twenty-six patients with type 2 diabetes were admitted for glycemic control. After admission, patients continued to be treated with optimal dietary therapy plus insulin therapy, with or without other antidiabetes drugs, until they achieved stable glycemic control. CGM measurements were made for 7 consecutive days. On Days 1-3, patients received insulin with or without other antidiabetes drugs, and on Days 4-7, teneligliptin 20 mg once daily at breakfast was added to ongoing therapy. Doses of insulin were fixed during the study. Levels of serum glycated albumin (GA), 1,5-anhydro-d-glucitol (1,5-AG), and high-sensitivity C-reactive protein (hsCRP) were measured.
Add-on treatment with teneligliptin led to significant improvements in 24-h mean glucose levels, the proportion of time in normoglycemia, mean amplitude of glycemic excursions, and total area under the curve within 2 h after each meal. The proportion of time in hypoglycemia and hsCRP levels did not increase significantly compared with before teneligliptin. Values of 1,5-AG and GA were significantly improved by treatment with teneligliptin.
Addition of teneligliptin to insulin therapy led to a significant improvement in diurnal glycemic control and significant reductions in glucose fluctuations in 24-h periods without increasing hypoglycemia in Japanese patients with type 2 diabetes on insulin therapy, with or without other antidiabetes agents.
本研究调查了新型二肽基肽酶-4抑制剂替奈利肽是否能改善接受胰岛素治疗的住院日本2型糖尿病患者的血糖波动情况,这些患者无论是否使用其他抗糖尿病药物,均采用持续葡萄糖监测(CGM)。
26例2型糖尿病患者因血糖控制入院。入院后,患者继续接受最佳饮食治疗加胰岛素治疗,无论是否使用其他抗糖尿病药物,直至血糖达到稳定控制。连续7天进行CGM测量。在第1 - 3天,患者接受胰岛素治疗,可联合或不联合其他抗糖尿病药物,在第4 - 7天,在正在进行的治疗基础上加用早餐时每日一次的替奈利肽20mg。研究期间胰岛素剂量固定。测量血清糖化白蛋白(GA)、1,5 - 脱水 - d - 葡萄糖醇(1,5 - AG)和高敏C反应蛋白(hsCRP)水平。
加用替奈利肽治疗后,24小时平均血糖水平、血糖正常时间比例、血糖波动平均幅度以及每餐餐后2小时内曲线下总面积均有显著改善。与加用替奈利肽前相比,低血糖时间比例和hsCRP水平未显著增加。替奈利肽治疗使1,5 - AG和GA值显著改善。
对于接受胰岛素治疗、无论是否使用其他抗糖尿病药物的日本2型糖尿病患者,在胰岛素治疗中加用替奈利肽可显著改善日间血糖控制,显著降低24小时内的血糖波动,且不增加低血糖发生风险。