Clinical observation on the combined therapy of sitagliptin with insulin for patients with brittle diabetes.
10.11817/j.issn.1672-7347.2015.10.006
- Author:
Na LUO
1
;
Yan ZHU
1
;
Zhenwen ZHANG
1
;
Hui CHEN
1
;
Yan WANG
1
Author Information
1. Department of Endocrinology, Subei People's Hospital, Yangzhou Jiangsu 225000, China.
- Publication Type:Journal Article
- MeSH:
Blood Glucose;
analysis;
C-Peptide;
blood;
Diabetes Mellitus, Type 1;
drug therapy;
Dipeptidyl-Peptidase IV Inhibitors;
Double-Blind Method;
Drug Therapy, Combination;
Gastric Inhibitory Polypeptide;
blood;
Glucagon;
blood;
Glucagon-Like Peptide 1;
blood;
Glycated Hemoglobin A;
analysis;
Humans;
Hypoglycemic Agents;
administration & dosage;
therapeutic use;
Insulin;
administration & dosage;
therapeutic use;
Sitagliptin Phosphate;
administration & dosage;
therapeutic use
- From:
Journal of Central South University(Medical Sciences)
2015;40(10):1089-1095
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To observe the clinical efficacy of sitagliptin plus insulin on patients with brittle diabetes and to determine the effect of the combined therapy on glucagon secretion.
METHODS:This randomized, double-blinded and placebo-controlled trial included 30 patients with brittle diabetes. Participants were randomly assigned (1:1) to receive the treatment of either sitagliptin plus insulin or placebo plus insulin for 12 weeks. The blood glucose, hemoglobin A1c, insulin dose, C-peptide, glucagon, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and other parameters were determined.
RESULTS:After 12 weeks of treatment, blood glucose was controlled better by sitagliptin plus insulin (P<0.01). The patients had significantly lower glucose variability indices, lower daily insulin requirement and hemoglobin A1c in the group of sitagliptin plus insulin (P<0.01). After steamed bun test, past-meal GLP-1 levels at 30 min were higher (P<0.01) while GIP levels were lower (P<0.01), with glucagon suppression in the sitagliptin plus insulin group. No significant change was observed at any time point in placebo plus insulin group.
CONCLUSION:Sitagliptin significantly decreases blood glucose level and blood glucose fluctuation, which may contribute to the ability of sitagliptin in decreasing glucagon secretion.
