Repa group, switched from sulfonylurea to repaglinide; SU group, continuing a sulfonylurea. Table 1 Clinical qualities from the scholarly study population thead valign=”best” th align=”still left” valign=”best” rowspan=”1″ colspan=”1″ Factors /th th align=”middle” valign=”best” rowspan=”1″ colspan=”1″ SU ( em n /em ?=?27) /th th align=”middle” valign=”best” rowspan=”1″ colspan=”1″ Repaglinide ( em n /em ?=?30) /th th align=”middle” valign=”top” rowspan=”1″ colspan=”1″ em P /em \worth /th /thead Age group (years)73.9??6.672.3??6.70.37Male sex (%)66.766.71.00Body mass index (kg/m2)21.4??2.2121.7??1.930.54FPG (mmol/L)8.38??1.548.2??2.570.74Glycated hemoglobin (%)7.52??0.437.44??0.470.50GA (%)? 21.0??2.421.0??3.00.97GA/HbA1c? 2.79??0.282.85??0.350.55IRI (U/mL) ? 4.41??3.304.50??3.500.93HOMA\IR? , ? 1.43 (0.88C1.92)1.36 (0.85C1.81)0.90HOMA\? 20.0??16.520.6??14.50.89SU (equal to glimepiride mg)1.20??0.670.97? 0.490.13Serum creatinine (mg/dL)0.81??0.210.85??0.230.52eGFR (mL/min/1.73?m2)68.6??18.865.8??16.90.56ALT (IU/mL)21.8??8.3421.3??14.20.87\GT (IU/mL)32.0??23.326.7??18.70.35TG (mg/dL)99.3??35.9107.3??55.70.52Total cholesterol (mg/dL)171??21.0175??27.70.56HDL cholesterol (mg/dL)59.5??14.862.2? 17.50.53LogUACR (mg/gCre)1.52??0.691.47??0.810.82Hypertension (%)66.766.71.00Dyslipidemia (%)81.576.70.66Metformin (%)81.570.00.37DPP\4 inhibitors (%)88.983.30.71SGLT2 inhibitors (%)7.47.01.00Thiazolidine (%)3.716.70.20\GI (%)22.217.61.00GLP\1RA (%)3.701.00Insulin (%)11.110.01.00Diabetic retinopathy (%)18.533.30.18Diabetic nephropathy (%)44.436.70.60 Hypoglycemic episodes (%)11.514.31.00Duration of diabetes 10?years (%)80.882.81.00History of taking SU 10?years (%)77.875.90.87 Open in another window Beliefs are mean??regular deviation or median (range). hypoglycemia and a larger influence on postprandial hyperglycemia, and so are recommended for use in older sufferers with type 2 diabetes particularly. We investigated the safety and efficacy of repaglinide weighed against sulfonylurea for the treating older sufferers. Strategies and Components In today’s multicenter, potential, randomized, open up\label, managed trial, 57 older low fat sufferers with type 2 diabetes who had been getting treated with sulfonylureas had been studied. These were either turned to repaglinide (Repa group) or continuing a sulfonylurea (SU group) for 12?weeks. The principal result comprised the obvious alter in glycemic control, and among the extra final results was the current presence of medication and hypoglycemia conformity. Outcomes Although glycated hemoglobin (HbA1c) had not been significantly different between your two groupings (SU +0.02% vs Repa ?0.07%), greater improvements in the glycated albumin (GA) and GA to HbA1c proportion (GA/HbA1c) were seen in the Repa group (GA, SU +0.12% vs Repa ?1.15%; Rabbit polyclonal to AHR GA/HbA1c, SU +0.01 vs Repa ?0.13; each em P? /em ?0.01) without increasing hypoglycemia. When the Repa group was subdivided regarding to whether GA improved, the SU dosage before switching to repaglinide was considerably smaller as well as the homeostatic model evaluation of \cell function was considerably higher in the GA improvement subgroup. Conclusions Switching from SU to Repa improved GA/HbA1c and GA, and had advantageous effects on blood sugar fluctuation in older sufferers with type 2 diabetes. solid course=”kwd-title” Keywords: Elderly, Glucose variability, Repaglinide Launch The system of actions of repaglinide requires the advertising of insulin discharge through the pancreas, like this of sulfonylureas (SUs), and its own principal aspect\effect contains hypoglycemia. Nevertheless, the chance of hypoglycemia when using repaglinide is known as to be possibly less than SUs1. Through the treatment of type 2 diabetes, the need for handling glycated hemoglobin (HbA1c) provides been proven in numerous huge\scale clinical research2, 3, 4. Nevertheless, as proven in the Actions to regulate Cardiovascular Risk in Diabetes (ACCORD) trial5, it’s important in order to avoid serious hypoglycemia also, but its occurrence isn’t shown in the HbA1c value usually. A link between postprandial hyperglycemia and macrovascular disease provides been proven in several prior studies, as well as the suppression of postprandial blood sugar can prevent atherosclerosis6. Daily glycemic fluctuations and high postprandial blood sugar donate to diabetic problems possibly, such as for example atherosclerosis, through even more glycation or oxidative tension7. Some research have also proven a link between cognitive impairment and postprandial hyperglycemia or daily severe blood sugar fluctuations8, 9. As a result, the avoidance of hypoglycemia and a decrease in postprandial hyperglycemia, with BMS-986158 lower glycemic fluctuation, is effective for seniors sufferers with type 2 diabetes especially. Analysis of constant blood sugar monitoring (CGM) systems to judge the glycemic control attained using SUs shows that BMS-986158 asymptomatic hypoglycemia is certainly common10, BMS-986158 11. Furthermore, SUs are insufficient to control postprandial hyperglycemia often. It is popular that insulin secretion has already been attenuated on the stage of impaired blood sugar tolerance in the Asian inhabitants, in accordance with the Western inhabitants12, which the capability to secrete insulin lowers through the development of diabetes steadily, leading to lower insulin secretion by older patients. BMS-986158 Furthermore, older patients have got lower muscle tissue, hence having much BMS-986158 less convenience of blood sugar disposal. Accordingly, postprandial hyperglycemia is more common in elderly patients than younger patients13. Glinides could therefore be indicated specifically for elderly patients with type 2 diabetes because of the lower risk of hypoglycemia associated with their use, and their greater effect on postprandial hyperglycemia. However, they have been believed to be less efficacious at lowering blood glucose than SUs. In contrast, our pilot study comparing the effects of repaglinide and SU on blood glucose revealed the superiority of repaglinide for glycemic control in lean elderly patients who had not reached their glycemic goal14. Here, we aimed to assess the use of repaglinide for glycemic control in lean elderly patients with type 2 diabetes in a multicenter, prospective, randomized, parallel\group comparison study design, which was based on our pilot study. Methods Study population We enrolled 57 patients with type 2 diabetes from seven medical service units located in Hokkaido, Japan (Hokkaido University Hospital, Kuriyama Red Cross Hospital, Hokkaido Spinal Cord Injury Center, Manda Memorial Hospital, Oki Medical Clinic, Kurihara Clinic and Aoki Clinic)..