Dataset Information

Improvement of glycemic control by treatment for insomnia with suvorexant in type 2 diabetes mellitus.

ABSTRACT:

Introduction

Acute and chronic insomnia can exacerbate type 2 diabetes mellitus (T2DM). We investigated suvorexant (an anti-insomnia drug that targets the orexin system) effects on sleep architecture and glucose metabolism in T2DM patients with insomnia.

Materials and methods

This 7?day open-label, single-arm, intervention trial included 18 subjects with T2DM and insomnia. After 1?day acclimatization, daily glucose levels, sleep architecture, and autonomic nervous function were evaluated by continuous glucose monitoring (CGM), single-channel electroencephalography, and accelerometry, respectively.

Results

Suvorexant treatment for 3?days significantly increased total sleep time and sleep efficiency, with partial suppression of sympathetic nerve activity. CGM-measured 24?h mean glucose level decreased significantly from 157.7?±?22.9 to 152.3?±?17.8?mg/dL, especially in the early glucose surge after the midnight nadir (from 28.3?±?15.0 to 18.2?±?9.9?mg/dL), and until supper with a significant improvement in homeostasis model assessment of insulin resistance from 4.0?±?2.8 to 2.9?±?1.6, respectively.

Conclusions

Suvorexant treatment for insomnia of subjects with T2DM significantly improved CGM-measured daily glycemic control, which was associated with changes in sympathomimetic tone and/or improved insulin sensitivity. The amelioration of insomnia may therefore be a target for improving glycemic control in T2DM patients with insomnia.

SUBMITTER: Toi N

PROVIDER: S-EPMC6306692 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Publications

Improvement of glycemic control by treatment for insomnia with suvorexant in type 2 diabetes mellitus.

Toi Norikazu N Inaba Masaaki M Kurajoh Masafumi M Morioka Tomoaki T Hayashi Noriyuki N Hirota Tomoe T Miyaoka Daichi D Emoto Masanori M Yamada Shinsuke S

Journal of clinical & translational endocrinology 20181218

<h4>Introduction</h4>Acute and chronic insomnia can exacerbate type 2 diabetes mellitus (T2DM). We investigated suvorexant (an anti-insomnia drug that targets the orexin system) effects on sleep architecture and glucose metabolism in T2DM patients with insomnia.<h4>Materials and methods</h4>This 7 day open-label, single-arm, intervention trial included 18 subjects with T2DM and insomnia. After 1 day acclimatization, daily glucose levels, sleep architecture, and autonomic nervous function were ev ...[more]

PMID: 30619717

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Project description:IntroductionLinagliptin is a xanthine-based dipeptidyl peptidase (DPP)-4 inhibitor that is now available in numerous countries worldwide for the treatment of type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate further the mechanisms underlying the improvements in glycemic control observed with linagliptin. The effects of linagliptin on DPP-4, pharmacodynamic parameters, and glycemic control versus placebo were assessed in patients with inadequately controlled T2DM.MethodsPatients in this phase 2a, multicenter, randomized, double-blind, placebo-controlled study received placebo (n = 40) or linagliptin 5 mg (n = 40). Sitagliptin 100 mg (n = 41) once daily for 4 weeks was included for exploratory purposes. Primary endpoints for linagliptin versus placebo: change from baseline to day 28 in 24-h weighted mean glucose (WMG) and intact glucagon-like peptide (GLP)-1 area under the time-effect curve between 0 and 2 h (AUEC(0-2h)) following meal tolerance test on day 28.ResultsLinagliptin increased intact GLP-1 AUEC(0-2h) (+18.1 pmol/h/L) and lowered 24-h WMG (-1.1 mmol/L) versus placebo (both P < 0.0001) after 28 days. Intact glucose-dependent insulinotropic polypeptide increased in line with GLP-1 (+91.4 pmol/h/L increase vs. placebo; P < 0.0001). Glycated hemoglobin (-0.22%; P = 0.0021), fasting plasma glucose (-0.6 mmol/L; P = 0.0283), and glucose (AUEC(0-3h)) (-5.9 mmol/h/L; P < 0.0001) improved significantly with linagliptin versus placebo. Most adverse events were mild; hypoglycemia or serious adverse events were not reported. Sustained DPP-4 inhibition (≥80%) throughout the treatment period was accompanied by significant reductions in glucagon starting at day 1 of linagliptin administration.ConclusionLinagliptin was well tolerated and effectively inhibited plasma DPP-4 activity in patients with T2DM, producing immediate improvements in incretin levels, glucagon suppression, and glycemic control that were maintained throughout the study period.

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Dataset Information

Improvement of glycemic control by treatment for insomnia with suvorexant in type 2 diabetes mellitus.

Introduction

Materials and methods

Results

Conclusions

Publications

Improvement of glycemic control by treatment for insomnia with suvorexant in type 2 diabetes mellitus.

Similar Datasets

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