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Erschienen in: International Journal of Diabetes in Developing Countries 4/2016

17.06.2015 | Original Article

A randomized controlled clinical trial of combination therapy for type 2 diabetes by vildagliptin, metformin, and α-glucosidase inhibitor

verfasst von: Qiong Wang, Yong Su, Lifang Lv

Erschienen in: International Journal of Diabetes in Developing Countries | Ausgabe 4/2016

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Abstract

This study aims to evaluate the efficacy and safety of vildagliptin combined with metformin and α-glucosidase inhibitors for treatment of type 2 diabetes. The type 2 diabetic patients with poor blood sugar control after a combination treatment by metformin and α-glucosidase inhibitor for at least two months were randomly assigned to receive vildagliptin or placebo (100 mg/day for 2 times) on the basis of the original treatment. The relevant indicators of the patients before and after the test for 12 weeks were detected. We totally chose 490 cases of subjects who were in Henan Provincial People’s Hospital from February,2013 to July,2013. Compared with the data before the test, the glycated hemoglobin (HbA1c) changed from 8.86 ± 1.820 to 6.74 ± 1.256 % and fasting blood glucose (FBG), postprandial blood glucose (PPG), and alanine aminotransferase (ALT) in the vildagliptin group significantly decreased; the difference was statistically significant (P < 0.05). The differences of the index in the placebo group were not statistically significant (P > 0.05). HbA1c in the vildagliptin group, 12 weeks after the test, was significantly lower than those in the placebo group with a comparison by 6.74 ± 1.256 and 8.20 ± 1.180 %, as well as FBG, PPG, ALT, and aspartate aminotransferase (AST); the difference was statistically significant (P < 0.05). Whether the comparisons were performed before and after treatment or between the two groups, the changes of the subject’s body weight and blood lipids had no statistically significant differences (P > 0.05). Vildagliptin combined with metformin and α-glucosidase inhibitors can efficiently reduce the FBG, PPG, and HbA1c of the patients without gaining weight and may have a protective effect on the liver.
Literatur
1.
Zurück zum Zitat Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359:l577–89. Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359:l577–89.
2.
Zurück zum Zitat Ahren B, Foley JE, Bosi E. Clinical evidence and mechanistic basis for vildagliptin’s action when added to metformin. Diabetes Obes Metab. 2011;13:193–203.CrossRefPubMed Ahren B, Foley JE, Bosi E. Clinical evidence and mechanistic basis for vildagliptin’s action when added to metformin. Diabetes Obes Metab. 2011;13:193–203.CrossRefPubMed
3.
Zurück zum Zitat Ahrén B. Clinical results of treating type 2 diabetic patients with sitagliptin, vildagliptin, or saxagliptin—diabetes control and potential adverse events. Best Pract Res Clin Endocrinol Metab. 2009;23:487–98.CrossRefPubMed Ahrén B. Clinical results of treating type 2 diabetic patients with sitagliptin, vildagliptin, or saxagliptin—diabetes control and potential adverse events. Best Pract Res Clin Endocrinol Metab. 2009;23:487–98.CrossRefPubMed
4.
Zurück zum Zitat Bosi E, Dotta F, Jia Y, Goodman M. Vildagliptin plus metformin combination therapy provides superior glycaemic control to individual monotherapy in treatment-naive patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2009;11:506–15.CrossRefPubMed Bosi E, Dotta F, Jia Y, Goodman M. Vildagliptin plus metformin combination therapy provides superior glycaemic control to individual monotherapy in treatment-naive patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2009;11:506–15.CrossRefPubMed
5.
Zurück zum Zitat Devendra D, Gohel B, Bravis V, Hui E, Salih S, Mehar S, et al. Vildagliptin therapy and hypoglycaemia in Muslim type 2 diabetes patients during Ramadan. Clin Pract. 2009;63:1446–50.CrossRef Devendra D, Gohel B, Bravis V, Hui E, Salih S, Mehar S, et al. Vildagliptin therapy and hypoglycaemia in Muslim type 2 diabetes patients during Ramadan. Clin Pract. 2009;63:1446–50.CrossRef
6.
Zurück zum Zitat Matthews DR, Dejager S, Ahren B, Fonseca V, Ferrannini E, Couturier A, et al. Vildagliptin add-on to metformin produces similar efficacy and reduced hypoglycaemic risk compared with glimepiride, with no weight gain: results from a 2-year study. Diabetes Obes Metab. 2010;12:780–9.CrossRefPubMed Matthews DR, Dejager S, Ahren B, Fonseca V, Ferrannini E, Couturier A, et al. Vildagliptin add-on to metformin produces similar efficacy and reduced hypoglycaemic risk compared with glimepiride, with no weight gain: results from a 2-year study. Diabetes Obes Metab. 2010;12:780–9.CrossRefPubMed
7.
Zurück zum Zitat Iwamoto Y, Kashiwagi A, Yamada N, Terao S, Mimori N, Suzuki M, et al. Efficacy and safety of vildagliptin and voglibose in Japanese patients with type 2 diabetes: a 12-week, randomized, double-blind, active-controlled study. Diabetes Obe Metab. 2010;12:700–8.CrossRef Iwamoto Y, Kashiwagi A, Yamada N, Terao S, Mimori N, Suzuki M, et al. Efficacy and safety of vildagliptin and voglibose in Japanese patients with type 2 diabetes: a 12-week, randomized, double-blind, active-controlled study. Diabetes Obe Metab. 2010;12:700–8.CrossRef
8.
Zurück zum Zitat Schweizer A, Dejager S, Foley JE, Shao Q, Kothny W. Clinical experience with vildagliptin in the management of type 2 diabetes in a patient population ≥75 years: a pooled analysis from a data base of clinical trials. Diabetes Obes Metab. 2011;13:55–64.CrossRefPubMed Schweizer A, Dejager S, Foley JE, Shao Q, Kothny W. Clinical experience with vildagliptin in the management of type 2 diabetes in a patient population ≥75 years: a pooled analysis from a data base of clinical trials. Diabetes Obes Metab. 2011;13:55–64.CrossRefPubMed
9.
Zurück zum Zitat Neumiller JJ. Differential chemistry (structure), mechanism faction, and pharmacology of GLP-1 receptor agonists and DPP-4 inhibitors. J Am Pharm Assoc. 2009;49:16–29.CrossRef Neumiller JJ. Differential chemistry (structure), mechanism faction, and pharmacology of GLP-1 receptor agonists and DPP-4 inhibitors. J Am Pharm Assoc. 2009;49:16–29.CrossRef
10.
Zurück zum Zitat Tahrani AA, Piya MK, Barnett AH. Drug evaluation: vildagliptin-metformin single-tablet combination. Adv Ther. 2009;26:138–54.CrossRefPubMed Tahrani AA, Piya MK, Barnett AH. Drug evaluation: vildagliptin-metformin single-tablet combination. Adv Ther. 2009;26:138–54.CrossRefPubMed
11.
Zurück zum Zitat Amori RE, Lau J, Pittas AG. Efficacy and safety of incretin therapy in type 2 diabetes: systematic review and meta-analysis. JAMA. 2007;298:194–206.CrossRefPubMed Amori RE, Lau J, Pittas AG. Efficacy and safety of incretin therapy in type 2 diabetes: systematic review and meta-analysis. JAMA. 2007;298:194–206.CrossRefPubMed
12.
Zurück zum Zitat Verspohl EJ. Novel therapeutics for type 2 diabetes: incretin hormone mimetics (glucagon-like peptide-1 receptor agonists) and dipeptidyl peptidase-4 inhibitors. Pharmacol Ther. 2009;124:113–38.CrossRefPubMed Verspohl EJ. Novel therapeutics for type 2 diabetes: incretin hormone mimetics (glucagon-like peptide-1 receptor agonists) and dipeptidyl peptidase-4 inhibitors. Pharmacol Ther. 2009;124:113–38.CrossRefPubMed
13.
Zurück zum Zitat Deacon CF, Holst JJ. Dipeptidyl peptidase IV inhibitors: a promising new therapeutic approach for the management of type 2 diabetes. Int J Biochem Cell Biol. 2006;38:831–44.CrossRefPubMed Deacon CF, Holst JJ. Dipeptidyl peptidase IV inhibitors: a promising new therapeutic approach for the management of type 2 diabetes. Int J Biochem Cell Biol. 2006;38:831–44.CrossRefPubMed
14.
Zurück zum Zitat Neumiller JJ, Wood L, Campbell RK. Dipeptidyl peptidase-4 inhibitors for the treatment of type 2 diabetes mellitus. Pharmacotherapy. 2010;30:463–84.CrossRefPubMed Neumiller JJ, Wood L, Campbell RK. Dipeptidyl peptidase-4 inhibitors for the treatment of type 2 diabetes mellitus. Pharmacotherapy. 2010;30:463–84.CrossRefPubMed
15.
Zurück zum Zitat Mikhail N. Safety of dipeptidyl peptidase 4 inhibitors for treatment of type 2 diabetes. Curr Drug Saf. 2011;6:304–9.CrossRefPubMed Mikhail N. Safety of dipeptidyl peptidase 4 inhibitors for treatment of type 2 diabetes. Curr Drug Saf. 2011;6:304–9.CrossRefPubMed
16.
Zurück zum Zitat Richard KR, Shelburne JS, Kirk JK. Tolerability of dipeptidyl peptidase-4 inhibitors: a review. Clin Ther. 2011;33:1609–29.CrossRefPubMed Richard KR, Shelburne JS, Kirk JK. Tolerability of dipeptidyl peptidase-4 inhibitors: a review. Clin Ther. 2011;33:1609–29.CrossRefPubMed
17.
Zurück zum Zitat Masuda K, Aoki K, Terauchi Y. Effects of miglitol taken just before or after breakfast on plasma glucose, serum insulin, glucagon and incretin levels after lunch in men with normal glucose tolerance, impaired fasting glucose or impaired glucose tolerance. Diabet Invest. 2011;2:435–40.CrossRef Masuda K, Aoki K, Terauchi Y. Effects of miglitol taken just before or after breakfast on plasma glucose, serum insulin, glucagon and incretin levels after lunch in men with normal glucose tolerance, impaired fasting glucose or impaired glucose tolerance. Diabet Invest. 2011;2:435–40.CrossRef
18.
Zurück zum Zitat Aoki K, Kamiyama H, Yoshimura K, Shibuya M, Masuda K, Terauchi Y. Miglitol administered before breakfast increased plasma active glucagon-like peptide-1 (GLP-1) levels after lunch in patients with type 2 diabetes treated with sitagliptin. Acta Diabetol. 2012;49:225–30.CrossRefPubMed Aoki K, Kamiyama H, Yoshimura K, Shibuya M, Masuda K, Terauchi Y. Miglitol administered before breakfast increased plasma active glucagon-like peptide-1 (GLP-1) levels after lunch in patients with type 2 diabetes treated with sitagliptin. Acta Diabetol. 2012;49:225–30.CrossRefPubMed
19.
Zurück zum Zitat Pi-Sunyer FX, Schweizer A, Mills D, Dejager S. Efficacy and tolerability of vildagliptin monotherapy in drug-naive patients with type 2 diabetes. Diabetes Res Clin Praet. 2007;76:132–8.CrossRef Pi-Sunyer FX, Schweizer A, Mills D, Dejager S. Efficacy and tolerability of vildagliptin monotherapy in drug-naive patients with type 2 diabetes. Diabetes Res Clin Praet. 2007;76:132–8.CrossRef
20.
Zurück zum Zitat Kahn SE, Haffner SM, Heise MA, Herman WH, Holman RR, Jones NP, et al. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. N Engl J Med. 2006;355:2427–43.CrossRefPubMed Kahn SE, Haffner SM, Heise MA, Herman WH, Holman RR, Jones NP, et al. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. N Engl J Med. 2006;355:2427–43.CrossRefPubMed
21.
Zurück zum Zitat Ligueros-Saylan M, Foley JE, Schweizer A, Couturier A, Kothny W. An assessment of adverse effects of vildagliptin versus comparators on the liver, the pancreas, the immune system, the skin and in patients with impaired renal function from a large pooled database of phase II and III clinical trials. Diabetes Obes Metab. 2010;12:495–509.CrossRefPubMed Ligueros-Saylan M, Foley JE, Schweizer A, Couturier A, Kothny W. An assessment of adverse effects of vildagliptin versus comparators on the liver, the pancreas, the immune system, the skin and in patients with impaired renal function from a large pooled database of phase II and III clinical trials. Diabetes Obes Metab. 2010;12:495–509.CrossRefPubMed
Metadaten
Titel
A randomized controlled clinical trial of combination therapy for type 2 diabetes by vildagliptin, metformin, and α-glucosidase inhibitor
verfasst von
Qiong Wang
Yong Su
Lifang Lv
Publikationsdatum
17.06.2015
Verlag
Springer India
Erschienen in
International Journal of Diabetes in Developing Countries / Ausgabe 4/2016
Print ISSN: 0973-3930
Elektronische ISSN: 1998-3832
DOI
https://doi.org/10.1007/s13410-015-0388-y

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