| アイテムタイプ |
文献 / Documents(1) |
| 公開日 |
2023-11-28 |
| アクセス権 |
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アクセス権 |
open access |
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アクセス権URI |
http://purl.org/coar/access_right/c_abf2 |
| 資源タイプ |
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資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
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資源タイプ |
journal article |
| 出版社版DOI |
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関連識別子 |
https://doi.org/10.1007/s13300-018-0486-1 |
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関連名称 |
10.1007/s13300-018-0486-1 |
| 出版タイプ |
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出版タイプ |
VoR |
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出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| タイトル |
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タイトル |
Up-Titration Strategy After DPP-4 Inhibitor-Based Oral Therapy for Type 2 Diabetes : A Randomized Controlled Trial Shifting to a Single-Dose GLP-1 Enhancer Versus Adding a Variable Basal Insulin Algorithm |
| 著者 |
ミヤギ, マサヒコ
ウチノ, ヒロシ
クマシロ, ナオキ
ヒガ, マリコ
シン, コウキ
ササモト, マキコ
キタザト, ヒロジ
田蒔, 基行
松久, 宗英
ヒロセ, タカヒサ
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| 抄録 |
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内容記述 |
Introduction: It is unclear whether adding basal insulin or enhancing incretin signaling with a glucagon-like peptide-1 receptor agonist (GLP-1RA) is more effective as an up-titration strategy after dipeptidyl peptidase-4 inhibitor (DPP-4i)-based oral antidiabetic drug (OAD) therapy. GLP-1RAs can be injected without dose adjustment, unlike basal insulin. Our objective was to examine the efficacy of changing patients inadequately controlled with oral DPP-4i-based OAD therapy to injectable GLP-1RA and discontinuing the DPP4i versus adding basal insulin glargine (IGlar) with the continuation of the oral DPP4i.
Methods: Sixty patients with type 2 diabetes (T2DM) and glycated hemoglobin (HbA1c) between 7.0% and 10.0% on DPP-4i-based OAD therapy were randomized to either adding IGlar and remaining on the DPP-4i or liraglutide and discontinuing the DPP-4i for 24 weeks. Patients in the IGlar group started with 0.1 unit/kg and were titrated according to the algorithm. In the liraglutide group, the DPP-4i was replaced with liraglutide 0.9 mg/day, the maximum dose in Japan. We evaluated HbA1c, glycated albumin (GA), and anthropometrics.
Results: HbA1c was significantly lower at week 24 (− 1.0 ± 0.9% in the IGlar group and − 0.6 ± 0.8% in the liraglutide group), but the difference between groups was not significant. Changes in GA were similar (− 2.9 ± 3.2% vs. − 2.6 ± 3.2%) in both groups. Body weight (BW) was significantly lower only in the liraglutide group (+ 0.5 ± 2.6 kg vs. − 2.2 ± 2.0 kg). The rate of minor hypoglycemic episodes was similar for both groups.
Conclusion: For poorly controlled T2DM on DPP-4i-based OAD therapy, switching to single-dose liraglutide to enhance incretin signaling is as effective as dose-titrated basal IGlar, but significant BW reduction was only seen in the liraglutide group. These results suggest that enhancing incretin signaling with a single-dose injectable GLP-1 RA might be an alternative to dose-titrated basal insulin therapy in patients with T2DM poorly controlled with DPP-4i-based OAD therapy. These findings should be confirmed in a longer and larger trial. |
| キーワード |
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主題 |
Dipeptidyl peptidase-4 inhibitor |
| キーワード |
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主題 |
Glargine |
| キーワード |
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主題 |
Liraglutide |
| 書誌情報 |
en : Diabetes Therapy
巻 9,
号 5,
p. 1959-1968,
発行日 2018-08-18
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| 収録物ID |
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収録物識別子タイプ |
ISSN |
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収録物識別子 |
18696961 |
| 収録物ID |
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収録物識別子タイプ |
ISSN |
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収録物識別子 |
18696953 |
| 出版者 |
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出版者 |
Springer Nature |
| 権利情報 |
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権利情報 |
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
| EID |
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識別子 |
352293 |
| 言語 |
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言語 |
eng |
dt_9_5_1959.pdf (1.11 MB)
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