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Addition of Mitiglinide to Pioglitazone Monotherapy Improves Glycemic Control in Japanese Patients with Type 2 Diabetes

This study examines the efficacy and safety of combining pioglitazone and metformin in Japanese patients with type 2 diabetes. The results demonstrate that the addition of mitiglinide to pioglitazone monotherapy effectively improves overall glycemic control.

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Addition of Mitiglinide to Pioglitazone Monotherapy Improves Glycemic Control in Japanese Patients with Type 2 Diabetes

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  1. Journal Club Kaku K, Tanaka SI, Origasa H, Kikuchi M, Akanuma Y.: Addition of Mitiglinide to Pioglitazone Monotherapy Improves Overall Glycemic Control in Japanese Patients with Type 2 Diabetes: A Randomized Double Blind Trial. Endocr J. 2009 Apr 7[Epub ahead of print] Kaku K. Efficacy and safety of therapy with metformin plus pioglitazone in the treatment of patients with type 2 diabetes: a double-blind, placebo-controlled, clinical trial. Curr Med Res Opin. 2009 May;25(5):1111-9. 埼玉医科大学　総合医療センター　内分泌・糖尿病内科 Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University 松田　昌文 Matsuda, Masafumi 2009年5月14日　8:30-8:55 ８階　医局

  2. Mechanism of Action of OHA α-glucosidase inhibitor SU drugs, glinides Gut Pancreas CHO abserption Hyperglycemia Defect in insuiin secretion = Deficiency of Insulin  Rd of glucose Insulin resistance = • Hepatic glucose • production Muscle Liver Thiazolidinedione Biguanide

  3. Combination SUdrugs α-glucosidase inhibitor Biguanide Thiazolidinedione Glinide Insulin American Diabetes Association Educational Slides

  4. Conclusions Mitiglinide effectively improves glycemic congrol in type 2 diabetic patients who are inadequeately controlled by pioglitazone monotherapy.

  5. Aim To assess the efficacy and safety of combination therapy with pioglitazone and metformin in Japanese patients with type 2 diabetes

  6. Methods During a 12-week observation period 236 patients were treated with metformin 500 or 750 mg/day. 169 patients with a confirmed HbA1c level ≧ 6.5% were randomized (stratified according to metformin dosage) to receive pioglitazone 15 mg/day for 12 weeks then increased to 30 mg/day for a further 16 weeks (n = 83), or placebo (n = 86). Outcome measures included HbA1c, fasting blood glucose (FBG), percentage of patients achieving HbA1c < 6.5%, lipid profile, and other metabolic parameters

  7. Interpretation Conclusion Pioglitazone plus metformin significantly improved glycemic control (HbA1c and FBG), and markers associated with increased insulin resistance and cardiovascular risk compared with metformin monotherapy. Clinical trial registration number: UMIN 000001110.

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