Table of Contents
International Scholarly Research Notices
Volume 2014, Article ID 639489, 6 pages
Clinical Study

Adding of Sitagliptin on Insulin Therapy Effectively and Safely Reduces a Hemoglobin A1c Level and Glucose Fluctuation in Japanese Patients with Type 2 Diabetes

1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan
2Municipal Yame General Hospital, Yame 834-0034, Japan
3Kouhoukai Takagi Hospital, Okawa 831-0016, Japan
4Inada Clinic, Kurume 830-0039, Japan
5Shimada Hospital, Ogori 838-0141, Japan
6Tenjinkai Koga Hospital 21, Kurume 839-0801, Japan
7Saint Mary Hospital, Kurume 830-8543, Japan
8Tenjinkai Shin-Koga Hospital, Kurume 830-8577, Japan

Received 10 March 2014; Accepted 5 June 2014; Published 3 August 2014

Academic Editor: Qi Zhang

Copyright © 2014 Yuji Tajiri et al. 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.


Aims. Efficacy and safety of DPP-4 inhibitor, sitagliptin, add-on therapy to insulin were investigated in Japanese patients with type 2 diabetes. Subjects and Methods. Two hundred and sixteen patients (126 men, 65 ± 12 years old, BMI 24.9 ± 4.5, means ± S.D.) who had been treated by insulin alone or insulin combined with other oral hypoglycemic agents (OHAs) were recruited, and sitagliptin was added for 3 months. Results. HbA1c was significantly decreased after 3 months of add-on therapy as a whole (8.56 ± 1.50% to 7.88 ± 1.25%, ). Body weight did not change and insulin dosage was significantly () decreased for 3 months. Furthermore, day-to-day glucose variability was significantly reduced (18.3 ± 9.1 to 16.1 ± 8.1%, ). In stepwise multiple regression analysis on ΔHbA1c as an outcome variable, the higher baseline HbA1c value and a preserved CPR were selected as significant predictive variables. Fifteen patients complained of mild hypoglycemia without any assistance during 3 months of sitagliptin add-on, while no severe hypoglycemic episode was reported. Conclusions. Add-on of sitagliptin to ongoing insulin therapy effectively reduced either HbA1c level or glucose fluctuation and could be a practical and well-tolerated alternative to treat Japanese patients with type 2 diabetes who had been inadequately controlled by insulin with or without other OHAs.