Add-On Treatment with Teneligliptin Ameliorates Glucose Fluctuations and Improves Glycemic Control Index in Japanese Patients with Type 2 Diabetes on Insulin Therapy

Abstract

Background: This study investigated whether teneligliptin, a novel dipeptidyl peptidase-4 inhibitor, ameliorated glucose fluctuations in hospitalized Japanese patients with type 2 diabetes receiving insulin therapy, with or without other antidiabetes drugs, and using continuous glucose monitoring (CGM). Patients and Methods: Twenty-six patients with type 2 diabetes were admitted for glycemic control. After admission, patients continued to be treated with optimal dietary therapy plus insulin therapy, with or without other antidiabetes drugs, until they achieved stable glycemic control. CGM measurements were made for 7 consecutive days. On Days 1-3, patients received insulin with or without other antidiabetes drugs, and on Days 4-7, teneligliptin 20 mg once daily at breakfast was added to ongoing therapy. Doses of insulin were fixed during the study. Levels of serum glycated albumin (GA), 1,5-anhydro-d-glucitol (1,5-AG), and high-sensitivity C-reactive protein (hsCRP) were measured. Results: Add-on treatment with teneligliptin led to significant improvements in 24-h mean glucose levels, the proportion of time in normoglycemia, mean amplitude of glycemic excursions, and total area under the curve within 2 h after each meal. The proportion of time in hypoglycemia and hsCRP levels did not increase significantly compared with before teneligliptin. Values of 1,5-AG and GA were significantly improved by treatment with teneligliptin. Conclusions: Addition of teneligliptin to insulin therapy led to a significant improvement in diurnal glycemic control and significant reductions in glucose fluctuations in 24-h periods without increasing hypoglycemia in Japanese patients with type 2 diabetes on insulin therapy, with or without other antidiabetes agents.

Teneligliptin improves left ventricular diastolic function and endothelial function in patients with diabetes

“…Teneligliptin, a novel peptidomimetic-chemotype prolylthiazolidine-based DPP-4 inhibitor, was approved for clinical use in 2013 in Japan [16]. The addition of teneligliptin has been reported to be effective, safe, and generally well tolerated in various types of Japanese patients with T2DM [17][18][19][20]. This study aimed to evaluate the cardio-protective effects of teneligliptin treatment in T2DM patients with a high risk of chronic heart failure.…”

Efficacy and safety of teneligliptin

“…In one Japanese study in T2DM patients receiving insulin therapy ( n = 26), with or without other antidiabetes drugs, teneligliptin was found to improve indices of glucose fluctuations (the SD of 24 h glucose levels and mean amplitude of glycemic excursions [MAGE]) using continuous glucose monitoring without inducing hypoglycemia. [25] In another very small ( n = 10) report from Japanese T2DM patients, 3 days of teneligliptin on ongoing insulin therapy found to improve 24 h glucose levels, SD of 24 h glucose levels, and MAGE. [26] Collectively, these results suggest improvement in glucose fluctuations with teneligliptin.…”

Efficacy and safety of teneligliptin add-on to insulin monotherapy in Japanese patients with type 2 diabetes mellitus: a 16-week, randomized, double-blind, placebo-controlled trial with an open-label period

“…In a prospective, unblinded, short-duration pilot study, addition of TNL to insulin therapy improved diurnal glucose and suppressed glycemic fluctuations assessed using continuous glucose monitoring, without increasing the frequency of hypoglycemia [18]. However, no randomized double-blind, placebo-controlled studies have yet assessed the safety and efficacy of TNL add-on to insulin monotherapy in Japanese T2DM patients.…”