Comparative Efficiency of Sulfonylurea and/or Dipeptidyl Peptidase-4 inhibitor in Basal-Supported Oral Therapy in Japanese Patients with Type 2 Diabetes (JDDM39)

Abstract

Basal-supported Oral Therapy (BOT), comprising treatment with oral antidiabetic drugs and once-daily injections of a long-acting insulin analog, is a convenient regimen. However, it sometimes fails to achieve satisfactory glycemic control because of uncontrolled hyperglycemia in the postprandial period. The aim of the present retrospective cohort study was to assess the efficiency of a sulfonylurea (SU) and/or a dipeptidyl peptidase-4 inhibitor (DPP-4i) on glycemic control in Japanese patients with type 2 diabetes mellitus (T2DM) who were receiving BOT. The 243 T2DM patients who started long-acting insulin added onto an SU and/or DPP-4i, with or without metformin, were followed-up for 6 months. Mean HbA1c levels in the SU, DPP-4i, and SU + DPP-4i groups decreased steadily from baseline by approximately 1% over the 6-month followed-up period. After 6 months, 57.4%, 51.6%, and 62.2% of patients in the SU, DPP-4i, and SU + DPP-4i groups, respectively, had continued on the same therapeutic regimen, and 15.2%, 18.5%, and 16.5% of patients, respectively, had achieved HbA1c levels <7.0%. The efficiency of BOT with SU, DPP-4i, and SU + DPP-4i was limited, but some patients (i.e. those with a lower body mass index and HbA1c) may benefit from these BOT regimens.