Ito Daisuke, Inoue Kazuyuki, Kaneko Kimie, Yanagisawa Morifumi, Sumita Takashi, Ikegami Yuichi, Awata Takuya, Ishida Hitoshi, Katayama Shigehiro, Inukai Kouichi
Division of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan ; Division of Internal Medicine, Ogawa Red Cross Hospital, 1525, Ogawa, Ogawa-machi, Hiki, Saitama 355-0397, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.
J Clin Med Res. 2015 May;7(5):303-7. doi: 10.14740/jocmr2057w. Epub 2015 Mar 1.
In Japan, dipeptidyl peptidase 4 (DPP4) inhibitors have become standard therapeutic agents for type 2 diabetes, and numbers of patients receiving insulin therapy combined with DPP4 inhibitors, which is a highly effective regimen, are increasing.
In this study, we evaluated the efficacy of vildagliptin administered at the dose of 100 mg twice daily in 57 patients with type 2 diabetes already receiving insulin treatment.
The 36 patients who simply received add-on vildagliptin showed a 0.6% decrease in HbA1c levels, despite a marked insulin dose reduction, mainly bolus insulin, of approximately 8.3 units. In addition, body mass index exhibited a significant negative correlation with the efficacy of vildagliptin, i.e., ΔHbA1c. On the other hand, the 21 patients switched from 50 mg of sitagliptin to vildagliptin showed HbA1c decreases approaching 0.7%.
Taking into consideration that twice-daily oral vildagliptin has already been reported to be advantageous in reducing postprandial hyperglycemia, this drug was suggested to be more effective in reducing HbA1c than sitagliptin under conditions in which it is used as a supplement to basal insulin, as in this study.
在日本，二肽基肽酶4（DPP4）抑制剂已成为2型糖尿病的标准治疗药物，接受胰岛素治疗联合DPP4抑制剂（一种高效治疗方案）的患者数量正在增加。
在本研究中，我们评估了每日两次服用100mg维格列汀对57例已接受胰岛素治疗的2型糖尿病患者的疗效。
单纯接受维格列汀附加治疗的36例患者，尽管胰岛素剂量显著减少，主要是推注胰岛素减少了约8.3单位，但糖化血红蛋白（HbA1c）水平仍下降了0.6%。此外，体重指数与维格列汀的疗效（即糖化血红蛋白变化值ΔHbA1c）呈显著负相关。另一方面，从50mg西格列汀转换为维格列汀的21例患者，糖化血红蛋白下降接近0.7%。
考虑到每日两次口服维格列汀已被报道在降低餐后高血糖方面具有优势，如本研究所示，在作为基础胰岛素补充剂使用的情况下，该药物在降低糖化血红蛋白方面比西格列汀更有效。
