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Clinical Characteristics of Japanese Type 2 Diabetic Patients Responsive to Sitagliptin

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Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo, Japan.
Foundation for Biomedical Research and Innovation, Hyogo, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Watanabe Medical Clinic, Hiroshima, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Department of Internal Medicine, Saitama Social Insurance Hospital, Saitama, Japan.
Sakado Central Hospital, Saitama, Japan.
Sakado Central Hospital, Saitama, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo, Japan.
Division of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Japanese type 2 diabetic patients were treated with sitagliptin to evaluate the efficacy of this agent, and also to investigate the clinical characteristics of those who responded to sitagliptin. In total, 1001 diabetic patients, inadequately controlled (HbA1c ≥ 6.5%) with oral hypoglycemic agents (OHA) other than DPP-4 inhibitors or with diet and exercise only, were enrolled. We added 50mg of sitagliptin to the therapeutic regimens of 410 patients including 68 OHA naive patients, while the other 591 patients were switched from a single OHA to 50 mg of sitagliptin. After 6 months, glycemic control was significantly improved due to both reduced insulin resistance, as demonstrated by a significant HOMA-R reduction, and recovery of pancreatic β cell function, as assessed by HOMA-β and the proinsulin/insulin (PI/I) ratio. In the bivariable analysis, a good response, defined as an HbA1c reduction during the 6 months of at least 0.9%, was associated with high HbA1c and PI/I at baseline and combination treatments with sulfonylurea, biguanide and α-glucosidase inhibitors, but not with obesity. On the other hand, in the multivariable regression analysis, only high baseline HbA1c and combination treatment with anα-glucosidase inhibitor were significantly associated with a good response to sitagliptin. In patients with type 2 diabetes, the addition of sitagliptin or switching from another OHA to this agent achieved an HbA1c reduction without overloading β cells. In particular, we suggest that a good response to sitagliptin can be expected when this agent is combined with an α-glucosidase inhibitor (UMIN No. #000014157).
Cite this paper
Inukai, K. , Hirata, T. , Sumita, T. , Watanabe, M. , Ikegami, Y. , Ito, D. , Kurihara, S. , Yasukawa, N. , Morimoto, J. , Takata, N. , Kanazawa, K. , Neda, T. , Sumitani, Y. , Inoue, K. , Noguchi, Y. , Hosaka, T. , Ishida, H. and Katayama, S. (2014) Clinical Characteristics of Japanese Type 2 Diabetic Patients Responsive to Sitagliptin. Journal of Diabetes Mellitus, 4, 172-178. doi: 10.4236/jdm.2014.43025. 
 

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