Low-dose glimepiride with sitagliptin improves glycemic control without dose-dependency in patients with type 2 diabetes inadequately controlled on high-dose glimepiride

Umayahara, Rieko; Yonemoto, Takako; Kyou, Chika; Morishita, Kae; Ogawa, Tsuneyoshi; Taguchi, Yoshitaka; Inoue, Tatsuhide

doi:10.1507/endocrj.ej14-0233

Cited by 5 publications

(6 citation statements)

References 15 publications

(19 reference statements)

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“…In such a case, SUs, including glibenclamide, or insulin secretagogues are commonly used in combination with DPP-IV inhibitors. However, some studies demonstrated that combination therapy with SUs may increase the risk of hypoglycemia between meals [4][5][6][7]. In our study, sitagliptin rapidly increased insulin levels, whereas glibenclamide did not stimulate insulin secretion immediately after glucose loading.…”

Section: Discussioncontrasting

confidence: 50%

“…Therefore, DPP-IV inhibitors need to be combined with SUs, insulin secretagogues, or biguanides, insulin sensitizers. In addition, because the combination of DPP-IV inhibitors and SUs may cause serious hypoglycemia, a reduction in the dose of SUs is recommended to prevent hypoglycemia [4][5][6][7]. A reduction in the dose of insulin secretagogues can prevent hypoglycemia, but it is considered that inadequate glycemic control is caused by the decreasing hypoglycemic effect.…”

Section: Comparison Of the Effects Of Mitiglinide And Glibenclamidementioning

confidence: 99%

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Comparison of the Effects of Mitiglinide and Glibenclamide Administered in Combination with the Dipeptidyl Peptidase-IV Inhibitor Sitagliptin in Rats with Streptozotocin-Nicotinamide-Induced Type 2 Diabetes

et al. 2017

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We compared the individual effects of mitiglinide and glibenclamide administered in combination with the dipeptidyl peptidase-IV (DPP-IV) inhibitor sitagliptin on plasma DPP-IV activity and blood glucose levels in rats with streptozotocin-nicotinamide-induced type 2 diabetes (STZ-NA rats). We examined the inhibitory activity of mitiglinide and glibenclamide as well as their combination with sitagliptin on plasma DPP-IV activity in STZ-NA rats. The oral glucose tolerance test (OGTT) was used to compare effects of mitiglinide, glibenclamide, and their combination with sitagliptin on blood glucose levels in STZ-NA rats. Mitiglinide and glibenclamide did not inhibit rat DPP-IV and did not influence the inhibitory effect of sitagliptin on rat plasma DPP-IV activity. In STZ-NA rats, plasma glucose levels were stronger suppressed by a combination of mitiglinide and sitagliptin than by either drug used alone. However, no clear effect of the combination of glibenclamide and sitagliptin was observed. These results indicate that the combination of mitiglinide and sitagliptin has a lower risk of hypoglycemia in the rats with induced type 2 diabetes compared with the combination of glibenclamide and sitagliptin. The combination of mitiglinide and sitagliptin can be a promising combination for the treatment of diabetic patients.

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Section: Discussioncontrasting

confidence: 50%

Section: Comparison Of the Effects Of Mitiglinide And Glibenclamidementioning

confidence: 99%

Comparison of the Effects of Mitiglinide and Glibenclamide Administered in Combination with the Dipeptidyl Peptidase-IV Inhibitor Sitagliptin in Rats with Streptozotocin-Nicotinamide-Induced Type 2 Diabetes

et al. 2017

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“…Furthermore, no hypoglycemic episodes were reported by various studies assessing the efficacy of sitagliptin and SU combinations. [ 111 124 ] Moreover, several studies reported that the combination treatments with sitagliptin and SU were safe and well tolerated in patients with T2DM. [ 111 117 118 ]…”

Section: S Ulfonylureas and C Ombinationmentioning

confidence: 99%

Consensus recommendations on sulfonylurea and sulfonylurea combinations in the management of Type 2 diabetes mellitus – International Task Force

Kalra

Bahendeka

Sahay

et al. 2018

Indian J Endocr Metab

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For decades, sulfonylureas (SUs) have been important drugs in the antidiabetic therapeutic armamentarium. They have been used as monotherapy as well as combination therapy. Focus on newer drugs and concerns about the risk of severe hypoglycemia and weight gain with some SUs have led to discussion on their safety and utility. It has to be borne in mind that the adverse events associated with SUs should not be ascribed to the whole class, as many modern SUs, such as glimepiride and gliclazide modified release, are associated with better safety profiles. Furthermore, individualization of treatment, using SUs in combination with other drugs, backed with careful monitoring and patient education, ensures maximum benefits with minimal side effects. The current guidelines, developed by experts from Africa, Asia, and the Middle East, promote the safe and smart use of SUs in combination with other glucose-lowering drugs.

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“…The efficacy of SUs for controlling blood glucose is well recognized, and these agents are often used as the second- or third-line OAD, or even as the first drug [ 1 , 2 ]. Beneficial effects of combination therapy with a DPP-4 inhibitor have also been reported [ 4 , 5 ]. Furthermore, SUs are economical to use.…”

Section: Introductionmentioning

confidence: 99%

Rationale and Design of the STOP-OB Study for Evaluating the Effects of Tofogliflozin and Glimepiride on Fat Deposition in Type 2 Diabetes Patients Treated with Metformin/DPP-4 Inhibitor Dual Therapy

Ishihara

Anai

Seino³

et al. 2018

Diabetes Ther

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BackgroundThe global pandemic of type 2 diabetes mellitus (T2DM) is an enormous clinical and socioeconomic burden. Biguanides and DPP-4 inhibitors (DPP-4i) are the most commonly used therapies in Japanese T2DM patients. When glycemic control is not adequate despite combination of these drugs, there is no consensus on the next step drug. Systematic reviews and meta-analyses of previous trials have indicated that glycemic control with triple combination therapies yields similar results. Thus, beneficial effects on cardiovascular risk factors may be important. The present study was designed to evaluate body fat percentage and several insulin resistance parameters after addition of tofogliflozin or glimepiride to the regimens of patients being treated with metformin and a DPP-4 inhibitor but failing to attain adequate blood glucose control.MethodsSodium glucose cotransporter-2 inhibitor, tofogliflozin versus glimepiride, comparative trial in patients with type 2 diabetes on body composition is an ongoing, multicenter, prospective, randomized, open-label, parallel-group trial. T2DM patients treated with metformin/DPP-4 inhibitor dual therapy have been recruited and randomly assigned to 20 mg/day tofogliflozin (n = 32) or 0.5 mg/day glimepiride (n = 32) groups, with either of these drugs being added to pre-existing regimens for 24 weeks.Planned OutcomesThe primary endpoint is the change in body fat percentage from baseline to 24 weeks. The secondary outcomes are changes in body composition other than fat percentage, body weight, parameters related to glycemic control and β-cell function, parameters related to lipids and arteriosclerosis, parameters related to liver function, parameters related to diabetic nephropathy, and uric acid levels. Safety parameters will also be analyzed. This is the first trial comparing the effects and safety of adding an SGLT2i and a sulfonylurea as the third-line oral agent to metformin/DPP-4i dual therapy. The results will provide valuable information for choosing third-line oral agents.Trial RegistrationUMIN000026161.FundingKowa Co. Ltd. and Kowa Pharmaceutical Co. Ltd., Tokyo, Japan.Electronic supplementary materialThe online version of this article (10.1007/s13300-018-0491-4) contains supplementary material, which is available to authorized users.

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Low-dose glimepiride with sitagliptin improves glycemic control without dose-dependency in patients with type 2 diabetes inadequately controlled on high-dose glimepiride

Cited by 5 publications

References 15 publications

Comparison of the Effects of Mitiglinide and Glibenclamide Administered in Combination with the Dipeptidyl Peptidase-IV Inhibitor Sitagliptin in Rats with Streptozotocin-Nicotinamide-Induced Type 2 Diabetes

Comparison of the Effects of Mitiglinide and Glibenclamide Administered in Combination with the Dipeptidyl Peptidase-IV Inhibitor Sitagliptin in Rats with Streptozotocin-Nicotinamide-Induced Type 2 Diabetes

Consensus recommendations on sulfonylurea and sulfonylurea combinations in the management of Type 2 diabetes mellitus – International Task Force

Rationale and Design of the STOP-OB Study for Evaluating the Effects of Tofogliflozin and Glimepiride on Fat Deposition in Type 2 Diabetes Patients Treated with Metformin/DPP-4 Inhibitor Dual Therapy

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