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Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study

Incretins reduce glycemic variability (GV) in patients with type 2 diabetes, but it is unknown whether switching from a combination of basal insulin and a DPP-4 inhibitor to insulin degludec/liraglutide (IDegLira) improves GV. We performed an exploratory prospective observational study to compare th...

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Autores principales: Oe, Yuki, Nomoto, Hiroshi, Nakamura, Akinobu, Kuwabara, Saki, Takahashi, Yuka, Yasui, Ayano, Izumihara, Rimi, Miya, Aika, Kameda, Hiraku, Cho, Kyu Yong, Atsumi, Tatsuya, Miyoshi, Hideaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793345/
https://www.ncbi.nlm.nih.gov/pubmed/35097130
http://dx.doi.org/10.1155/2022/5603864
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author Oe, Yuki
Nomoto, Hiroshi
Nakamura, Akinobu
Kuwabara, Saki
Takahashi, Yuka
Yasui, Ayano
Izumihara, Rimi
Miya, Aika
Kameda, Hiraku
Cho, Kyu Yong
Atsumi, Tatsuya
Miyoshi, Hideaki
author_facet Oe, Yuki
Nomoto, Hiroshi
Nakamura, Akinobu
Kuwabara, Saki
Takahashi, Yuka
Yasui, Ayano
Izumihara, Rimi
Miya, Aika
Kameda, Hiraku
Cho, Kyu Yong
Atsumi, Tatsuya
Miyoshi, Hideaki
author_sort Oe, Yuki
collection PubMed
description Incretins reduce glycemic variability (GV) in patients with type 2 diabetes, but it is unknown whether switching from a combination of basal insulin and a DPP-4 inhibitor to insulin degludec/liraglutide (IDegLira) improves GV. We performed an exploratory prospective observational study to compare the effect of IDegLira and the combination on GV. We recruited hospitalized patients with type 2 diabetes who had stable glycemic control with insulin degludec (≤16 units/day) and taking a DPP-4 inhibitor. GV was analyzed using continuous glucose monitoring (CGM) before and after switching the medication to IDegLira. The principal endpoint was the change in mean amplitude of glycemic excursions (MAGE). Other indices of GV and CGM parameters were analyzed as the secondary endpoints. Fifteen participants were enrolled and 12 completed the study. In these participants, the DPP-4 inhibitor and insulin degludec were discontinued, and the equivalent dose of IDegLira was commenced. Switching to IDegLira significantly improved MAGE from 74.9 (60.3, 97.7) mg/dL to 64.8 (52.0, 78.2) mg/dL (P < 0.05), as well as other indices of GV and 24-hour mean blood glucose concentration. Analysis of the ambulatory glucose profile showed marked reductions in postprandial glucose concentration. Nocturnal glucose concentration was similar under the two treatment regimens. IDegLira improved GV as well as the mean and the postprandial glucose concentration by switching from insulin degludec plus DPP-4 inhibitor combination. IDegLira might be beneficial for patients being treated with low-dose basal insulin.
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spelling pubmed-87933452022-01-28 Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study Oe, Yuki Nomoto, Hiroshi Nakamura, Akinobu Kuwabara, Saki Takahashi, Yuka Yasui, Ayano Izumihara, Rimi Miya, Aika Kameda, Hiraku Cho, Kyu Yong Atsumi, Tatsuya Miyoshi, Hideaki J Diabetes Res Research Article Incretins reduce glycemic variability (GV) in patients with type 2 diabetes, but it is unknown whether switching from a combination of basal insulin and a DPP-4 inhibitor to insulin degludec/liraglutide (IDegLira) improves GV. We performed an exploratory prospective observational study to compare the effect of IDegLira and the combination on GV. We recruited hospitalized patients with type 2 diabetes who had stable glycemic control with insulin degludec (≤16 units/day) and taking a DPP-4 inhibitor. GV was analyzed using continuous glucose monitoring (CGM) before and after switching the medication to IDegLira. The principal endpoint was the change in mean amplitude of glycemic excursions (MAGE). Other indices of GV and CGM parameters were analyzed as the secondary endpoints. Fifteen participants were enrolled and 12 completed the study. In these participants, the DPP-4 inhibitor and insulin degludec were discontinued, and the equivalent dose of IDegLira was commenced. Switching to IDegLira significantly improved MAGE from 74.9 (60.3, 97.7) mg/dL to 64.8 (52.0, 78.2) mg/dL (P < 0.05), as well as other indices of GV and 24-hour mean blood glucose concentration. Analysis of the ambulatory glucose profile showed marked reductions in postprandial glucose concentration. Nocturnal glucose concentration was similar under the two treatment regimens. IDegLira improved GV as well as the mean and the postprandial glucose concentration by switching from insulin degludec plus DPP-4 inhibitor combination. IDegLira might be beneficial for patients being treated with low-dose basal insulin. Hindawi 2022-01-19 /pmc/articles/PMC8793345/ /pubmed/35097130 http://dx.doi.org/10.1155/2022/5603864 Text en Copyright © 2022 Yuki Oe et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Oe, Yuki
Nomoto, Hiroshi
Nakamura, Akinobu
Kuwabara, Saki
Takahashi, Yuka
Yasui, Ayano
Izumihara, Rimi
Miya, Aika
Kameda, Hiraku
Cho, Kyu Yong
Atsumi, Tatsuya
Miyoshi, Hideaki
Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study
title Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study
title_full Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study
title_fullStr Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study
title_full_unstemmed Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study
title_short Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study
title_sort switching from insulin degludec plus dipeptidyl peptidase-4 inhibitor to insulin degludec/liraglutide improves glycemic variability in patients with type 2 diabetes: a preliminary prospective observation study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793345/
https://www.ncbi.nlm.nih.gov/pubmed/35097130
http://dx.doi.org/10.1155/2022/5603864
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