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Kim YA, Yoo WS, Hong ES, et al. Clinical Characteristics and Metabolic Predictors of Rapid Responders to Dipeptidyl Peptidase-4 Inhibitor as an Add-on Therapy to Sulfonylurea and Metformin. Diabetes Metab J. 2015;39(6):489-97doi: 10.4093/dmj.2015.39.6.489.
Kim, Y. A., Yoo, W. S., Hong, E. S., Ku, E. J., Park, K. S., Lim, S., Cho, Y. M., Park, K. S., Jang, H. C., & Choi, S. H. (2015). Clinical Characteristics and Metabolic Predictors of Rapid Responders to Dipeptidyl Peptidase-4 Inhibitor as an Add-on Therapy to Sulfonylurea and Metformin. Diabetes & metabolism journal, 39(6), 489-97. https://doi.org/10.4093/dmj.2015.39.6.489
Kim, Ye An, et al. "Clinical Characteristics and Metabolic Predictors of Rapid Responders to Dipeptidyl Peptidase-4 Inhibitor as an Add-on Therapy to Sulfonylurea and Metformin." Diabetes & metabolism journal vol. 39,6 (2015): 489-97. doi: https://doi.org/10.4093/dmj.2015.39.6.489
Kim YA, Yoo WS, Hong ES, Ku EJ, Park KS, Lim S, Cho YM, Park KS, Jang HC, Choi SH. Clinical Characteristics and Metabolic Predictors of Rapid Responders to Dipeptidyl Peptidase-4 Inhibitor as an Add-on Therapy to Sulfonylurea and Metformin. Diabetes Metab J. 2015 Dec;39(6):489-97. doi: 10.4093/dmj.2015.39.6.489. Epub 2015 Nov 27. PMID: 26616595; PMCID: PMC4696985.
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Diabetes Metab J. 2015 Dec;39(6):489-97. doi: 10.4093/dmj.2015.39.6.489. Epub 2015 Nov 27.

Clinical Characteristics and Metabolic Predictors of Rapid Responders to Dipeptidyl Peptidase-4 Inhibitor as an Add-on Therapy to Sulfonylurea and Metformin.

Diabetes & metabolism journal

Ye An Kim, Won Sang Yoo, Eun Shil Hong, Eu Jeong Ku, Kyeong Seon Park, Soo Lim, Young Min Cho, Kyong Soo Park, Hak Chul Jang, Sung Hee Choi

Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  2. Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
  3. Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
  4. Department of Internal Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.
  5. Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
  6. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  7. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. [email protected].

PMID: 26616595 PMCID: PMC4696985 DOI: 10.4093/dmj.2015.39.6.489

Abstract

BACKGROUND: Dipeptidyl peptidase-4 (DPP-4) inhibitor add-on therapy is a new option for patients with inadequately controlled type 2 diabetes who are taking combined metformin and sulfonylurea (SU). We evaluated the efficacy and safety of this triple therapy and the characteristics of rapid responders and hypoglycemia-prone patients.

METHODS: We included 807 patients with type 2 diabetes who were prescribed a newly added DPP-4 inhibitor to ongoing metformin and SU in 2009 to 2011. Glycemia and other metabolic parameters at baseline, 12, 24, and 52 weeks, as well as episodes of hypoglycemia were analyzed. Rapid responders were defined as patients with ≥25% reduction in glycosylated hemoglobin (HbA1c) within 12 weeks.

RESULTS: At baseline, while on the submaximal metformin and SU combination, the mean HbA1c level was 8.4%. Twelve weeks after initiation of DPP-4 inhibitor add-on, 269 patients (34.4%) achieved an HbA1c level ≤7%. Sixty-six patients (8.2%, 47 men) were rapid responders. The duration of diabetes was shorter in rapid responders, and their baseline fasting plasma glucose (FPG), HbA1c, C-peptide, and homeostasis model assessment of insulin resistance were significantly higher. Patients who experienced hypoglycemia after taking DPP-4 inhibitor add-on were more likely to be female, to have a lower body weight and lower triglyceride and FPG levels, and to have higher homeostasis model assessment of β-cells.

CONCLUSION: An oral hypoglycemic triple agent combination including a DPP-4 inhibitor was effective in patients with uncontrolled diabetes. Proactive dose reduction of SU should be considered when a DPP-4 inhibitor is added for rapid responders and hypoglycemia-prone patients.

Keywords: Combination; Diabetes mellitus, type 2; Dipeptidyl-peptidase IV inhibitors; Hypoglycemia; Response; Sulfonylurea compounds

References

  1. Diabetes Metab J. 2011 Aug;35(4):411-7 - PubMed
  2. Endocr J. 2011;58(7):519-25 - PubMed
  3. Diabetes Metab J. 2011 Jun;35(3):290-7 - PubMed
  4. Diabetes Res Clin Pract. 2012 Feb;95(2):e27-8 - PubMed
  5. J Diabetes Investig. 2010 Apr 22;1(1-2):37-9 - PubMed
  6. Jpn Clin Med. 2012 Feb 16;3:1-7 - PubMed
  7. J Diabetes Investig. 2012 Mar 28;3(2):175-8 - PubMed
  8. Diabetes Obes Metab. 2013 Jan;15(1):55-61 - PubMed
  9. Endocr Rev. 2007 Apr;28(2):187-218 - PubMed
  10. Endocrinology. 2011 Aug;152(8):3018-29 - PubMed
  11. Int J Clin Pharm. 2012 Dec;34(6):917-24 - PubMed
  12. Diabetes Obes Metab. 2009 Aug;11(8):813-8 - PubMed
  13. Diabetes Metab J. 2011 Apr;35(2):159-65 - PubMed
  14. Diabetes Obes Metab. 2012 Sep;14(9):795-802 - PubMed
  15. Pharmaceutics. 2012 Sep 19;4(3):479-93 - PubMed
  16. Int J Clin Pract. 2012 May;66(5):465-76 - PubMed
  17. Science. 1998 Dec 18;282(5397):2275-9 - PubMed
  18. Nature. 1998 Dec 3;396(6710):474-7 - PubMed
  19. Diabetes Care. 2007 Aug;30(8):1979-87 - PubMed
  20. Diabetes Obes Metab. 2007 Sep;9(5):733-45 - PubMed
  21. Curr Med Res Opin. 2011 Jun;27(6):1169-74 - PubMed
  22. Diabetes Metab Res Rev. 2011 May;27(4):362-72 - PubMed
  23. JAMA. 1999 Jun 2;281(21):2005-12 - PubMed
  24. Diabetologia. 1985 Jul;28(7):412-9 - PubMed

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