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Original Article
Glycemic Effectiveness of Metformin-Based Dual-Combination Therapies with Sulphonylurea, Pioglitazone, or DPP4-Inhibitor in Drug-Naïve Korean Type 2 Diabetic Patients
Young Ki Lee, Sun Ok Song, Kwang Joon Kim, Yongin Cho, Younjeong Choi, Yujung Yun, Byung-Wan Lee, Eun-Seok Kang, Bong Soo Cha, Hyun Chul Lee
Diabetes Metab J. 2013;37(6):465-474.   Published online December 12, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.6.465
  • 6,021 View
  • 79 Download
  • 18 Crossref
AbstractAbstract PDFPubReader   
Background

This study compared the glycemic effectiveness of three metformin-based dual therapies according to baseline hemoglobin A1c (HbA1c) to evaluate the appropriateness of the guideline enforced by the National Health Insurance Corporation of Korea for initial medication of type 2 diabetes (T2D).

Methods

This prospective observational study was conducted across 24 weeks for drug-naïve Korean T2D patients with HbA1c greater than 7.5%. Subjects were first divided into three groups based on the agent combined with metformin (group 1, gliclazide-modified release or glimepiride; group 2, pioglitazone; group 3, sitagliptin). Subjects were also classified into three categories according to baseline HbA1c (category I, 7.5%≤HbA1c<9.0%; category II, 9.0%≤HbA1c<11.0%; category III, 11.0%≤HbA1c).

Results

Among 116 subjects, 99 subjects completed the study, with 88 subjects maintaining the initial medication. While each of the metformin-based dual therapies showed a significant decrease in HbA1c (group 1, 8.9% to 6.4%; group 2, 9.0% to 6.6%; group 3, 9.3% to 6.3%; P<0.001 for each), there was no significant difference in the magnitude of HbA1c change among the groups. While the three HbA1c categories showed significantly different baseline HbA1c levels (8.2% vs. 9.9% vs. 11.9%; P<0.001), endpoint HbA1c was not different (6.4% vs. 6.6% vs. 6.0%; P=0.051).

Conclusion

The three dual therapies using a combination of metformin and either sulfonylurea, pioglitazone, or sitagliptin showed similar glycemic effectiveness among drug-naïve Korean T2D patients. In addition, these regimens were similarly effective across a wide range of baseline HbA1c levels.

Citations

Citations to this article as recorded by  
  • Benefits and risks of drug combination therapy for diabetes mellitus and its complications: a comprehensive review
    Xueqin Xie, Changchun Wu, Yuduo Hao, Tianyu Wang, Yuhe Yang, Peiling Cai, Yang Zhang, Jian Huang, Kejun Deng, Dan Yan, Hao Lin
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Estimation of Serum Creatinine, Aspartate Aminotransferase, Alanine Transaminase, and Hemoglobin A1c% Levels among Diabetic Patients using Metformin/Dipeptide Peptidase-4 Inhibitor Combination and Insulin – A Cross-Sectional Study
    Arshiya Shadab, Ilma Hussain, Praveen Kumar Kandakurti, Marwan Ismail, Ahmed Luay Osman Hashim, Salah Eldin Omar Hussein, Altoum Abd Elgadir
    Open Access Macedonian Journal of Medical Sciences.2022; 10(B): 959.     CrossRef
  • Acarbose Add-on Therapy in Patients with Type 2 Diabetes Mellitus with Metformin and Sitagliptin Failure: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study
    Hae Kyung Yang, Seung-Hwan Lee, Juyoung Shin, Yoon-Hee Choi, Yu-Bae Ahn, Byung-Wan Lee, Eun Jung Rhee, Kyung Wan Min, Kun-Ho Yoon
    Diabetes & Metabolism Journal.2019; 43(3): 287.     CrossRef
  • Initial combination therapy with vildagliptin plus metformin in drug-naïve patients with T2DM: a 24-week real-life study from Asia
    Manoj Chawla, Tae Ho Kim, Roberto C. Mirasol, Pathan Faruque, Kathryn Cooke, Peggy Hours-Zesiger, Abhijit Shete
    Current Medical Research and Opinion.2018; 34(9): 1605.     CrossRef
  • Consensus recommendations on sulfonylurea and sulfonylurea combinations in the management of Type 2 diabetes mellitus – International Task Force
    Sanjay Kalra, Silver Bahendeka, Rakesh Sahay, Sujoy Ghosh, Fariduddin Md, Abbas Orabi, Kaushik Ramaiya, Sameer Al Shammari, Dina Shrestha, Khalid Shaikh, Sachitha Abhayaratna, PradeepK Shrestha, Aravinthan Mahalingam, Mazen Askheta, AlyAhmed A. Rahim, Fat
    Indian Journal of Endocrinology and Metabolism.2018; 22(1): 132.     CrossRef
  • Efficacy and safety of sitagliptin/metformin fixed‐dose combination compared with glimepiride in patients with type 2 diabetes: A multicenter randomized double‐blind study
    Sang Soo Kim, In Joo Kim, Kwang Jae Lee, Jeong Hyun Park, Young Il Kim, Young Sil Lee, Sung Chang Chung, Sang Jin Lee
    Journal of Diabetes.2017; 9(4): 412.     CrossRef
  • Short‐term intensive insulin therapy could be the preferred option for new onset Type 2 diabetes mellitus patients with HbA1c > 9%
    Jianping Weng
    Journal of Diabetes.2017; 9(10): 890.     CrossRef
  • The efficacy and safety of adding either vildagliptin or glimepiride to ongoing metformin therapy in patients with type 2 diabetes mellitus
    Gyuri Kim, Sewon Oh, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim, Moon-Kyu Lee
    Expert Opinion on Pharmacotherapy.2017; 18(12): 1179.     CrossRef
  • Effects of pioglitazone therapy on blood parameters, weight and BMI: a meta-analysis
    Elena Filipova, Katya Uzunova, Krassimir Kalinov, Toni Vekov
    Diabetology & Metabolic Syndrome.2017;[Epub]     CrossRef
  • Is insulin the preferred treatment for HbA1c >9%?
    Zachary Bloomgarden
    Journal of Diabetes.2017; 9(9): 814.     CrossRef
  • Effectiveness of sitagliptin compared to sulfonylureas for type 2 diabetes mellitus inadequately controlled on metformin: a systematic review and meta-analysis
    Manuj Sharma, Nicholas Beckley, Irwin Nazareth, Irene Petersen
    BMJ Open.2017; 7(10): e017260.     CrossRef
  • The effect of pioglitazone on weight, lipid profile and liver enzymes in type 2 diabetic patients
    Nasser Aghamohammadzadeh, Mitra Niafar, Elham Dalir Abdolahinia, Farzad Najafipour, Saeed Mohamadzadeh Gharebaghi, Khadijeh Adabi, Elaheh Dalir Abdolahinia, Hamidreza Ahadi
    Therapeutic Advances in Endocrinology and Metabolism.2015; 6(2): 56.     CrossRef
  • Glycated Albumin Levels in Patients with Type 2 Diabetes Increase Relative to HbA1cwith Time
    Hye-jin Yoon, Yong-ho Lee, Kwang Joon Kim, So Ra Kim, Eun Seok Kang, Bong-Soo Cha, Hyun Chul Lee, Byung-Wan Lee
    BioMed Research International.2015; 2015: 1.     CrossRef
  • Four-Year Durability of Initial Combination Therapy with Sitagliptin and Metformin in Patients with Type 2 Diabetes in Clinical Practice; COSMIC Study
    Eu Jeong Ku, Kyong Yeon Jung, Yoon Ji Kim, Kyoung Min Kim, Jae Hoon Moon, Sung Hee Choi, Young Min Cho, Kyong Soo Park, Hak Chul Jang, Soo Lim, Bo Ahrén, Giorgio Sesti
    PLOS ONE.2015; 10(6): e0129477.     CrossRef
  • Comparative analysis of therapeutic efficiency and costs (experience in Bulgaria) of oral antidiabetic therapies based on glitazones and gliptins
    Elena Pavlova Filipova, Katya Hristova Uzunova, Toni Yonkov Vekov
    Diabetology & Metabolic Syndrome.2015;[Epub]     CrossRef
  • Interactions of DPP-4 and integrin β1 influences endothelial-to-mesenchymal transition
    Sen Shi, Swayam Prakash Srivastava, Megumi Kanasaki, Jianhua He, Munehiro Kitada, Takako Nagai, Kyoko Nitta, Susumu Takagi, Keizo Kanasaki, Daisuke Koya
    Kidney International.2015; 88(3): 479.     CrossRef
  • Sodium Glucose Co-transporter 2 (SGLT2) Inhibitors: New among Antidiabetic Drugs
    L. H. Opie
    Cardiovascular Drugs and Therapy.2014; 28(4): 331.     CrossRef
  • Metformin Based Dual-Combination Therapies in Drug Naïve Type 2 Diabetic Patients
    Dong-Lim Kim
    Diabetes & Metabolism Journal.2013; 37(6): 429.     CrossRef
Review
Neonatal Diabetes Caused by Activating Mutations in the Sulphonylurea Receptor
Peter Proks
Diabetes Metab J. 2013;37(3):157-164.   Published online June 14, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.3.157
  • 4,382 View
  • 55 Download
  • 10 Crossref
AbstractAbstract PDFPubReader   

Adenosine triphosphate (ATP)-sensitive potassium (KATP) channels in pancreatic β-cells play a crucial role in insulin secretion and glucose homeostasis. These channels are composed of two subunits: a pore-forming subunit (Kir6.2) and a regulatory subunit (sulphonylurea receptor-1). Recent studies identified large number of gain of function mutations in the regulatory subunit of the channel which cause neonatal diabetes. Majority of mutations cause neonatal diabetes alone, however some lead to a severe form of neonatal diabetes with associated neurological complications. This review focuses on the functional effects of these mutations as well as the implications for treatment.

Citations

Citations to this article as recorded by  
  • Long-term Follow-up of Glycemic and Neurological Outcomes in an International Series of Patients With Sulfonylurea-Treated ABCC8 Permanent Neonatal Diabetes
    Pamela Bowman, Frances Mathews, Fabrizio Barbetti, Maggie H. Shepherd, Janine Sanchez, Barbara Piccini, Jacques Beltrand, Lisa R. Letourneau-Freiberg, Michel Polak, Siri Atma W. Greeley, Eamon Rawlins, Tarig Babiker, Nicholas J. Thomas, Elisa De Franco, S
    Diabetes Care.2021; 44(1): 35.     CrossRef
  • Structure based analysis of KATP channel with a DEND syndrome mutation in murine skeletal muscle
    Shoichiro Horita, Tomoyuki Ono, Saul Gonzalez-Resines, Yuko Ono, Megumi Yamachi, Songji Zhao, Carmen Domene, Yuko Maejima, Kenju Shimomura
    Scientific Reports.2021;[Epub]     CrossRef
  • Clinical and Genetic Characteristics of ABCC8 Nonneonatal Diabetes Mellitus: A Systematic Review
    Meng Li, Xueyao Han, Linong Ji, Karim Gariani
    Journal of Diabetes Research.2021; 2021: 1.     CrossRef
  • Spacial models of malfunctioned protein complexes help to elucidate signal transduction critical for insulin release
    Katarzyna Walczewska-Szewc, Wieslaw Nowak
    Biosystems.2019; 177: 48.     CrossRef
  • Cantu syndrome–associated SUR2 (ABCC9) mutations in distinct structural domains result in KATP channel gain-of-function by differential mechanisms
    Conor McClenaghan, Alex Hanson, Monica Sala-Rabanal, Helen I. Roessler, Dragana Josifova, Dorothy K. Grange, Gijs van Haaften, Colin G. Nichols
    Journal of Biological Chemistry.2018; 293(6): 2041.     CrossRef
  • Hyperinsulinism-Causing Mutations Cause Multiple Molecular Defects in SUR1 NBD1
    Claudia P. Alvarez, Marijana Stagljar, D. Ranjith Muhandiram, Voula Kanelis
    Biochemistry.2017; 56(18): 2400.     CrossRef
  • KATP Channel Mutations and Neonatal Diabetes
    Kenju Shimomura, Yuko Maejima
    Internal Medicine.2017; 56(18): 2387.     CrossRef
  • Molecular action of sulphonylureas on KATP channels: a real partnership between drugs and nucleotides
    Heidi de Wet, Peter Proks
    Biochemical Society Transactions.2015; 43(5): 901.     CrossRef
  • Successful development and use of a thermodynamic stability screen for optimizing the yield of nucleotide binding domains
    Elvin D. de Araujo, Voula Kanelis
    Protein Expression and Purification.2014; 103: 38.     CrossRef
  • Reclasificación y transferencia de insulina a sulfonilureas en un paciente con mutación en KCNJ11 tras 15 años de tratamiento con insulina
    Magdalena Capponi, Carmen Quirós, Ignacio Conget, Enric Esmatjes, Marga Giménez
    Avances en Diabetología.2014; 30(4): 115.     CrossRef

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