Glycemic/metabolic responses to identical meal tolerance tests at breakfast, lunch and dinner in Japanese patients with type 2 diabetes mellitus treated with a dipeptidyl peptidase-4 inhibitor and the effects of adding a mitiglinide/voglibose fixed-dose combination. (September 2014)

• Record Type: Journal Article
• Authors: Ono, Yuri; Kamoshima, Hikaru; Nakamura, Akinobu; Nomoto, Hiroshi
• Is Part Of: Expert opinion on pharmacotherapy. Volume 15:Number 13(2014)
• Page Start: 1785
• Page End: 1795
• Publication Date: 2014-09
• Subjects: Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1517/14656566.2014.939070
• Languages: English
• ISSNs: 1465-6566

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold> <italic>Background:</italic> </bold> The effects of the mitiglinide/voglibose fixed-dose combination on postprandial glycemic/metabolic responses in patients with type 2 diabetes mellitus (T2DM) treated with dipeptidyl peptidase-4 (DPP-4) inhibitors are unknown.</p> <p> <bold> <italic>Methods:</italic> </bold> Twelve T2DM patients treated with a DPP-4 inhibitor underwent identical meal tolerance tests (MTTs) at breakfast, lunch and dinner, before and 2 – 3 weeks after treatment with a fixed-dose combination of mitiglinide 10 mg and voglibose 0.2 mg (combination). Patients were randomized in a cross-over fashion to administer the combination either three-times-daily before each meal or twice-daily before breakfast and dinner. Glycemic/metabolic responses were evaluated at 0, 30, 60 and 120 min in each MTT.</p> <p> <bold> <italic>Results:</italic> </bold> Three-times-daily administration of the combination significantly suppressed postprandial hyperglycemia after each meal, particularly after lunch and dinner. Active glucagon-like peptide-1 levels increased significantly after each meal, as did early-phase insulin secretion without excessive insulin secretion. Postprandial hyperglycemia after lunch was significantly greater after twice-daily than three-times-daily administration, but there were no clinically relevant differences in other metabolic responses.</p> <p> <bold> <italic>Conclusion:</italic> </bold> This study revealed that adding the mitiglinide/voglibose combination to a DPP-4 inhibitor elicited additive improvements in postprandial glycemic/metabolic responses assessed using MTTs at breakfast, lunch and dinner with identical meal compositions.</p> </abstract>