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西他列汀对初治或对现有抗糖尿病药物反应不佳的2型糖尿病患者血糖控制的影响:JAMP研究

Effect of sitagliptin on blood glucose control in patients with type 2 diabetes mellitus who are treatment naive or poorly responsive to existing antidiabetic drugs: the JAMP study.

作者信息

Sakura Hiroshi, Hashimoto Naotake, Sasamoto Kazuo, Ohashi Hiroshi, Hasumi Sumiko, Ujihara Noriko, Kasahara Tadasu, Tomonaga Osamu, Nunome Hideo, Honda Masashi, Iwamoto Yasuhiko

机构信息

Department of Medicine, Medical Center East, Tokyo Women's Medical University School of Medicine , 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan.

Department of Diabetes, Endocrine and Metabolic Diseases, Tokyo Women's Medical University Yachiyo Medical Center, 477-96, Owada-shinden, Yachiyo-shi, Chiba, 276-8524, Japan.

出版信息

BMC Endocr Disord. 2016 Dec 1;16(1):70. doi: 10.1186/s12902-016-0149-z.

Abstract

BACKGROUND

To investigate the ameliorating effect of sitagliptin, a dipeptidyl peptidase-4 inhibitor, on blood glucose control in patients with type 2 diabetes mellitus who were previously untreated with or who have a poor responsive to existing antidiabetic drugs.

METHODS

Sitagliptin (50 mg/day) was added on to the pre-existing therapy for type 2 diabetes and changes in the glycated hemoglobin (HbA1c) level after 3 months of treatment were compared with the baseline and performed exploratory analysis.

RESULTS

HbA1c levels were significantly decreased after 1 month of treatment compared to baseline, with a mean change in HbA1c level from baseline of -0.73% (range, -0.80 to -0.67) in the entire study population at 3 months. Patients who received a medium dose of glimepiride showed the least improvement in HbA1c levels. The percentage of patients who achieved an HbA1c level of <7.0% significantly increased after 1 month of treatment, reaching 53.1% at 3 months. The percentage of patients who achieved a fasting blood glucose level of <130 mg/dL significantly increased after 1 month of treatment, reaching 50.9% at 3 months.

CONCLUSIONS

Sitagliptin improved the HbA1c level and rate of achieving the target control levels in patients with type 2 diabetes mellitus who were previously untreated with, or poorly responsive to, existing antidiabetic drugs. Thus, sitagliptin is expected to be useful in this patient group. However, the additional administration of sitagliptin in patients treated with medium-dose glimepiride only slightly improved blood glucose control when corrected for baseline HbA1c level.

摘要

背景

探讨二肽基肽酶-4抑制剂西他列汀对既往未接受过治疗或对现有抗糖尿病药物反应不佳的2型糖尿病患者血糖控制的改善作用。

方法

在2型糖尿病患者原有的治疗方案基础上加用西他列汀(50毫克/天),将治疗3个月后的糖化血红蛋白(HbA1c)水平变化与基线水平进行比较,并进行探索性分析。

结果

与基线相比,治疗1个月后HbA1c水平显著降低,在整个研究人群中,3个月时HbA1c水平相对于基线的平均变化为-0.73%(范围为-0.80至-0.67)。接受中剂量格列美脲治疗的患者HbA1c水平改善最少。治疗1个月后,HbA1c水平<7.0%的患者百分比显著增加,3个月时达到53.1%。治疗1个月后,空腹血糖水平<130毫克/分升的患者百分比显著增加,3个月时达到50.9%。

结论

西他列汀改善了既往未接受过治疗或对现有抗糖尿病药物反应不佳的2型糖尿病患者的HbA1c水平及达到目标控制水平的比例。因此,西他列汀有望对该患者群体有用。然而,在仅接受中剂量格列美脲治疗的患者中加用西他列汀,在校正基线HbA1c水平后,血糖控制仅略有改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d239/5133763/0ac8bac10c80/12902_2016_149_Fig1_HTML.jpg

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