Relationship between the efficacy of oral antidiabetic drugs and clinical features in type 2 diabetic patients (JDDM38)

Abstract

Aims/IntroductionWe carried out an observational cohort study to examine the relationship between the efficacy of oral antidiabetic drugs and clinical features in type 2 diabetics.Materials and MethodsWe analyzed the CoDiC® database of the Japan Diabetes Data Management Study Group across 67 institutions in Japan. In a total of 3,698 drug‐naïve patients who were initiated with metformin, dipeptidyl peptidase‐4 inhibitor (DPP‐4i) or sulfonylurea (SU) from 2007 to 2012, we evaluated body mass index (BMI) and hemoglobin A1c (HbA1c). The patients were stratified according to their clinical features, and matched using a propensity score to adjust for baseline factors.ResultsHbA1c was reduced with all drugs, with the largest effect elicited by DPP‐4i and the smallest by SU (P = 0.00). HbA1c increased with SU after 6 months in the patients stratified by an age‐of‐onset of <50 years (P = 0.00). BMI increased with SU in the patients stratified by a BMI of <25 (P = 0.00), and decreased with metformin in the patients with a BMI >25 (P = 0.00). The reduction in HbA1c was larger in patients with HbA1c of ≥8%, compared with that in patients with HbA1c of <8% (P = 0.00). HbA1c during the study period was higher in patients who were added to or swapped with other drug(s), than in patients continued on the original drug (P = 0.00).ConclusionsThe effect on bodyweight and glycemic control differed among metformin, DPP‐4i and SU, and the difference was associated with clinical features.

Safety and Mode of Action of Diabetes Medications in comparison with 5-Aminolevulinic Acid (5-ALA)

“…Similar trends were observed for HbA1c, but results were of borderline significance ( p = 0.07) [34]. Another study in Japan was conducted with on individuals who demonstrated mild hyperglycemia (fasting plasma glucose 105-125 mg/dL (5.8 mmol/L–6.9 mmol/L) or hemoglobin (Hb)A1c 6.1%-7.1%); they were randomly assigned to 4 groups with different doses of ALA: the results showed reduced fasting and 2 h post-OGTT plasma glucose levels after 3 months [39], and both studies reported no adverse effects [40, 41].…”

Canagliflozin for the treatment of type 2 diabetes: a comparison between Japanese and non-Japanese patients

“…Increased body mass index (BMI) is associated with T2DM [15,16]. BMI in T2DM is gradually increasing in Japan [17], and the average BMI of Japanese patients with T2DM is about 24-25 kg/m 2 [17][18][19][20]. Although this is lower than the BMI of Caucasian and non-Asian patients [15,16,20], Japanese patients with BMI ≥23 kg/m 2 develop insulin resistance [21] and have increased cardiovascular risk [22].…”

Preferential prescribing of linagliptin in type 2 diabetes patients in an expanded post‐marketing surveillance study in Japan

“…As such, information from these surveillance studies might be challenging to put into context if no additional recent clinical practice data from the respective patient population already exists. Importantly, other studies in Japan have shown that differences among type 2 diabetes mellitus patient age, duration of diabetes, obesity and glycemic control at baseline influenced treatment choice, and bodyweight and glycemic control differed among metformin, DPP‐4 inhibitors and sulfonylureas in accordance with differences in patient clinical features. Furthermore, type 2 diabetes mellitus patients often have a significant burden of comorbid conditions, which might impact treatment choice.…”