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

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Abstract

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.

Original languageEnglish
Pages (from-to)465-474
Number of pages10
JournalDiabetes and Metabolism Journal
Volume37
Issue number6
DOIs
Publication statusPublished - 2013 Dec 1

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pioglitazone
Metformin
Hemoglobins
Pharmaceutical Preparations
Therapeutics
Type 2 Diabetes Mellitus
glimepiride
Gliclazide

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

Lee, Young Ki ; Song, Sun Ok ; Kim, Kwang Joon ; Cho, Yongin ; Choi, Younjeong ; Yun, Yujung ; Lee, Byung Wan ; Kang, Eun Seok ; Cha, Bong Soo ; Lee, Hyun Chul. / Glycemic effectiveness of metformin-based dual-combination therapies with sulphonylurea, pioglitazone, or DPP4-inhibitor in drug-naïve Korean type 2 diabetic patients. In: Diabetes and Metabolism Journal. 2013 ; Vol. 37, No. 6. pp. 465-474.
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abstract = "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-na{\"i}ve 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-na{\"i}ve Korean T2D patients. In addition, these regimens were similarly effective across a wide range of baseline HbA1c levels.",
author = "Lee, {Young Ki} and Song, {Sun Ok} and Kim, {Kwang Joon} and Yongin Cho and Younjeong Choi and Yujung Yun and Lee, {Byung Wan} and Kang, {Eun Seok} and Cha, {Bong Soo} and Lee, {Hyun Chul}",
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Glycemic effectiveness of metformin-based dual-combination therapies with sulphonylurea, pioglitazone, or DPP4-inhibitor in drug-naïve Korean type 2 diabetic patients. / Lee, Young Ki; Song, Sun Ok; Kim, Kwang Joon; Cho, Yongin; Choi, Younjeong; Yun, Yujung; Lee, Byung Wan; Kang, Eun Seok; Cha, Bong Soo; Lee, Hyun Chul.

In: Diabetes and Metabolism Journal, Vol. 37, No. 6, 01.12.2013, p. 465-474.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Glycemic effectiveness of metformin-based dual-combination therapies with sulphonylurea, pioglitazone, or DPP4-inhibitor in drug-naïve Korean type 2 diabetic patients

AU - Lee, Young Ki

AU - Song, Sun Ok

AU - Kim, Kwang Joon

AU - Cho, Yongin

AU - Choi, Younjeong

AU - Yun, Yujung

AU - Lee, Byung Wan

AU - Kang, Eun Seok

AU - Cha, Bong Soo

AU - Lee, Hyun Chul

PY - 2013/12/1

Y1 - 2013/12/1

N2 - 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.

AB - 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.

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