Atsushi Mikada1, Takuma Narita2, Hiroki Yokoyama3, Risa Yamashita3, Yohei Horikawa4, Katsushi Tsukiyama5, Yuichiro Yamada6. 1. Akita University Graduate School of Medicine, Department of Endocrinology, Diabetes and Geriatric Medicine, Akita, Japan; Hiraka General Hospital, Gastroenterology and Diabetes Unit, Yokote, Japan. 2. Akita University Graduate School of Medicine, Department of Endocrinology, Diabetes and Geriatric Medicine, Akita, Japan. Electronic address: narita@med.akita-u.ac.jp. 3. Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan. 4. Hiraka General Hospital, Gastroenterology and Diabetes Unit, Yokote, Japan. 5. Hiraka General Hospital, Gastroenterology and Diabetes Unit, Yokote, Japan; Akita University School of Medicine, Metabolism and Clinical Nutrition, Akita, Japan. 6. Akita University Graduate School of Medicine, Department of Endocrinology, Diabetes and Geriatric Medicine, Akita, Japan.
Abstract
AIM: To assess changes in circulating incretin levels and body fat compositions with initial combination therapy with α-glucosidase inhibitor and dipeptidyl peptidase-4 inhibitor in patients with type 2 diabetes (T2D). METHODS: In this multicenter open-label 24-week trial, Japanese over-weight (BMI ≥ 25 kg/m(2)) patients with T2D not taking medication or takingmetformin and/or sulfonylurea were randomly assigned to receive either 50mg of miglitol three times a day (M, n=14), 50mg of sitagliptin once a day (S, n=14), or a combination of both (M+S, n=13). Changes in plasma incretin levels during a meal tolerance test (MTT) and body fat composition with impedance method were evaluated. RESULTS: During MTT, postprandial plasma glucose levels decreased more after M+S than after M or S, and postprandial serum insulin levels decreased significantly after M and M+S whereas they increased after S. After M, active gastric inhibitory polypeptide (aGIP) decreased significantly at 30 min despite a significant increase at 120 min. After S, aGIP levels increased significantly throughout the MTT. After M+S, aGIP increased significantly at 0 and 120 min despite of significant decrease at 30 min. M+S further enhanced postprandial active glucagon-like peptide-1 levels during MTT than S did. Total body fat mass decreased significantly after M and M+S. Visceral fat mass decreased significantly only after M+S. Serum adiponectin increased significantly only after M+S. CONCLUSIONS: In over-weight patients with T2D, M+S may have a beneficial effect on adiposity with relation to these different effects on two incretins.
RCT Entities:
AIM: To assess changes in circulating incretin levels and body fat compositions with initial combination therapy with α-glucosidase inhibitor and dipeptidyl peptidase-4 inhibitor in patients with type 2 diabetes (T2D). METHODS: In this multicenter open-label 24-week trial, Japanese over-weight (BMI ≥ 25 kg/m(2)) patients with T2D not taking medication or taking metformin and/or sulfonylurea were randomly assigned to receive either 50mg of miglitol three times a day (M, n=14), 50mg of sitagliptin once a day (S, n=14), or a combination of both (M+S, n=13). Changes in plasma incretin levels during a meal tolerance test (MTT) and body fat composition with impedance method were evaluated. RESULTS: During MTT, postprandial plasma glucose levels decreased more after M+S than after M or S, and postprandial serum insulin levels decreased significantly after M and M+S whereas they increased after S. After M, active gastric inhibitory polypeptide (aGIP) decreased significantly at 30 min despite a significant increase at 120 min. After S, aGIP levels increased significantly throughout the MTT. After M+S, aGIP increased significantly at 0 and 120 min despite of significant decrease at 30 min. M+S further enhanced postprandial active glucagon-like peptide-1 levels during MTT than S did. Total body fat mass decreased significantly after M and M+S. Visceral fat mass decreased significantly only after M+S. Serum adiponectin increased significantly only after M+S. CONCLUSIONS: In over-weight patients with T2D, M+S may have a beneficial effect on adiposity with relation to these different effects on two incretins.
Authors: Linong Ji; Juliana C N Chan; Miao Yu; Kun Ho Yoon; Sin Gon Kim; Sung Hee Choi; Chien-Ning Huang; Shih Te Tu; Chih-Yuan Wang; Päivi Maria Paldánius; Wayne H H Sheu Journal: Diabetes Obes Metab Date: 2020-11-09 Impact factor: 6.577