Optimal Candidates for the Switch from Glimepiride to Sitagliptin to Reduce Hypoglycemia in Patients with Type 2 Diabetes Mellitus
Endocrinology and Metabolism
; : 84-91, 2015.
Article
de En
| WPRIM
| ID: wpr-150114
Bibliothèque responsable:
WPRO
ABSTRACT
BACKGROUND: Sitagliptin is a novel antidiabetic agent with a low risk for hypoglycemia. We investigated the efficacy and safety of sitagliptin when patients switched from a sulfonylurea to sitagliptin and identified good candidates for the switch. METHODS: Sixty-one patients with type 2 diabetes switched from glimepiride with metformin to sitagliptin with metformin due to clinical hypoglycemia. Serum glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and 2-hour postprandial plasma glucose (2h-PPG) before and 12 and 24 weeks after the drug switch were checked. RESULTS: HbA1c and FPG levels did not change 12 or 24 weeks after the switch; however, the 2h-PPG level decreased from 218.0+/-67.5 mg/dL at baseline to 197.1+/-69.9 mg/dL at 12 weeks and 192.3+/-67.4 mg/dL at 24 weeks after switching drugs (P=0.045, P=0.018, respectively). All but one patient no longer experienced hypoglycemia after discontinuing glimepiride. In a multivariate logistic regression analysis, a high homeostasis model assessment of insulin resistance and low baseline HbA1c level were independent predictors of an HbA1c < or =7% after switching to sitagliptin. CONCLUSION: Glycemic control was not aggravated in patients 24 weeks after the drug switch, and symptomatic hypoglycemia decreased significantly. Patients with dominant insulin resistance may be good candidates for switching from a sulfonylurea to sitagliptin to reduce hypoglycemia.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Glycémie
/
Hémoglobine glyquée
/
Insulinorésistance
/
Modèles logistiques
/
Jeûne
/
Diabète de type 2
/
Phosphate de sitagliptine
/
Homéostasie
/
Hypoglycémie
/
Metformine
Type d'étude:
Prognostic_studies
/
Risk_factors_studies
Limites du sujet:
Humans
langue:
En
Texte intégral:
Endocrinology and Metabolism
Année:
2015
Type:
Article