- 作者：Fuminori Tatsumi ; Mitsuru Hashiramoto ; Hidenori Hirukawa ; Tomohiko Kimura ; Masashi Shimoda ; Kazuhito Tawaramoto ; Yukiko K ; a-Kimura ; Takatoshi Anno ; Fumiko Kawasaki ; Tomoatsu Mune ; Michihiro Matsuki ; Kohei Kaku
- 关键词：Miglitol ; Mitiglinide ; Initial combination ; GLP-1 ; GIP
- 刊名：Diabetes Research and Clinical Practice
- 出版年：2013
- 出版时间：July, 2013
- 年：2013
- 卷：101
- 期：1
- 页码：35-44
- 全文大小：1275 K
Aim
To evaluate the efficacy of miglitol and mitiglinide alone or in combination on the metabolic profile and incretin secretion in Japanese type 2 diabetes patients.Methods
Patients on diet and exercise with or without metformin, were randomized to receive either miglitol, mitiglinide, or a combination, three times daily for 12 weeks.
Results
At 12 weeks, HbA1c decreased significantly (p < 0.001) and 1,5-AG increased significantly (p < 0.001) in all three groups, with the greatest change seen with combination therapy. Effective improvement of postprandial hyperglycemia was demonstrated by a meal-loading test in all three interventions but serum insulin concentration was not increased by miglitol. In a subset of patients without prior metformin administration, faster and better glycemic control was achieved with the initial combination. After meal loading, serum total GLP-1 significantly increased only with miglitol monotherapy (p < 0.05) and serum total GIP significantly decreased (p < 0.01) in the arms employing miglitol after 12 weeks.
Conclusion
Miglitol/mitiglinide combination is more potent than monotherapy in improving glycemic control through the reduction of postprandial glucose excursion and the simultaneous sparing of additional insulin secretion. A marked difference in the effects of miglitol and mitiglinide on incretin secretion was also demonstrated.