Takahara Mitsuyoshi, Shiraiwa Toshihiko, Katakami Naoto, Maeno Yoshifumi, Yamamoto Kaoru, Shiraiwa Yuka, Yoshida Yoko, Matsuoka Taka-Aki, Shimomura Iichiro
Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
Shiraiwa Medical Clinic, Kashiwara, Osaka 582-0005, Japan.
Endocr J. 2019 Jan 28;66(1):11-17. doi: 10.1507/endocrj.EJ18-0313. Epub 2018 Oct 11.
The aim of this study was to investigate whether daily glycemic profiles and treatment satisfaction would be changed after switching from once-daily 25-mg alogliptin plus twice-daily 250-mg metformin to the fixed-dose combination of 25-mg alogliptin and 500-mg metformin once daily in type 2 diabetic patients. Twenty adult Japanese type 2 diabetic patients in whom once-daily 25-mg alogliptin plus twice-daily 250-mg metformin were switched to the fixed-dose combination of 25-mg alogliptin and 500-mg metformin once daily participated. Before and one month after the switch, participants were asked to perform one day of seven-point self-monitoring of blood glucose (SMBG), to wear a sensor of flash glucose monitoring for up to 14 days, and to respond to a questionnaire for treatment satisfaction. As a result, the SMBG profiles were significantly changed after the switch (p = 0.021); blood glucose levels 2 hours after breakfast were significantly elevated (p = 0.022), whereas those 2 hours after lunch were significantly reduced (p = 0.036). The flash glucose monitoring also demonstrated a significant change of daily glucose profiles (p < 0.001). The risk of glucose levels <80 mg/dL were decreased from evening to morning, while the risk of glucose levels ≥140 mg/dL were increased. Mean 24-hour glucose values were increased by 5 mg/dL on average (p < 0.001). Treatment satisfaction was significantly improved after the switch (p < 0.001). In conclusion, daily glycemic profiles were significantly changed after switching from once-daily 25-mg alogliptin plus twice-daily 250-mg metformin to the once-daily fixed-dose combination in Japanese type 2 diabetic patients. Treatment satisfaction was significantly improved after the switch.
本研究的目的是调查2型糖尿病患者从每日一次25毫克阿格列汀加每日两次250毫克二甲双胍转换为每日一次25毫克阿格列汀与500毫克二甲双胍的固定剂量组合后,每日血糖谱和治疗满意度是否会发生变化。20名成年日本2型糖尿病患者参与了研究,他们从每日一次25毫克阿格列汀加每日两次250毫克二甲双胍转换为每日一次25毫克阿格列汀与500毫克二甲双胍的固定剂量组合。在转换前和转换后一个月,要求参与者进行一天的七点自我血糖监测(SMBG),佩戴连续14天的动态血糖监测传感器,并回答治疗满意度问卷。结果显示,转换后SMBG谱有显著变化(p = 0.021);早餐后2小时血糖水平显著升高(p = 0.022),而午餐后2小时血糖水平显著降低(p = 0.036)。动态血糖监测也显示每日血糖谱有显著变化(p < 0.001)。血糖水平<80 mg/dL的风险从晚上到早上降低,而血糖水平≥140 mg/dL的风险增加。平均24小时血糖值平均升高了5 mg/dL(p < 0.001)。转换后治疗满意度显著提高(p < 0.001)。总之,日本2型糖尿病患者从每日一次25毫克阿格列汀加每日两次250毫克二甲双胍转换为每日一次固定剂量组合后,每日血糖谱有显著变化。转换后治疗满意度显著提高。