The aim of this study was to evaluate the effect of gemigliptin vs sitagliptin or glimepiride as initial combination therapy with metformin on glycaemic variability and to assess the correlation between glycaemic variability reduction and the dipeptidyl peptidase-4 (DPP-4) inhibition in patients with type 2 diabetes. This multicentre, randomized, active-controlled, open-label exploratory study included 69 patients with HbA1c > 7.5%. Subjects were randomized to receive gemigliptin 50 mg (n = 24), sitagliptin 100 mg (n = 23) or glimepiride 2 mg (n = 22) for 12 weeks. After 12 weeks, the change in mean amplitude of glycaemic excursion (MAGE) compared with baseline was significantly lower in the DPP-4 inhibitor groups compared with that in patients who received glimepiride. Furthermore, the standard deviation (SD) of glucose was significantly lower in patients who received gemigliptin than that in patients who received sitagliptin or glimepiride. The DPP-4 inhibition was significantly correlated with changes in MAGE and SD of glucose. In conclusion, gemigliptin and sitagliptin were more effective than glimepiride in reducing glycaemic variability as initial combination therapy with metformin in patients with type 2 diabetes, and the DPP-4 inhibition was associated with a reduction in glycaemic variability.
Bibliographical noteFunding Information:
The authors thank the staff who conducted the study, the patients for their participation and the industry sponsor (LG Life Sciences, Seoul, Republic of Korea) for coordination and funding of the study. Gwong C. Hur, Sung H. Kim, and Young H. Jang are LG Life Sciences employees. None of the other authors reported potential conflicts of interest relevant to this study. S. E. P. collected data and wrote the manuscript. B. W. L., J. H. K., C. H. J. and S. H. L. collected data. S. S. evaluated the data. W. J. L., J. H. C., G. C. H., Y. H. J. and S. H. K. contributed to the design of the study. C. Y. P. contributed to the design of the study, interpretation of the data and manuscript editing. All authors reviewed and approved the final manuscript.
All Science Journal Classification (ASJC) codes
- Internal Medicine
- Endocrinology, Diabetes and Metabolism