Dataset Information

Effects of Repaglinide Versus Glimepiride on 1,5-Anhydroglucutol and Glycated Hemoglobin Levels in Japanese Patients With Type 2 Diabetes.

ABSTRACT: Background:Postprandial hyperglycemia is a well-known risk factor for cardiovascular disease. We prospectively examined the effects of repaglinide on postprandial hyperglycemia in patients with type 2 diabetes. Methods:During this 24-week, single-arm, prospective study, we enrolled 10 patients with type 2 diabetes who were previously being administered glimepiride (0.5 or 1 mg/day) and switched it with repaglinide (0.75 or 1.5 mg/day). Changes in their metabolic parameters were evaluated at the end of the study period. Results:After replacing glimepiride with repaglinide, increases were observed in 1,5-anhydroglucitol levels (baseline, 5.46 ± 1.96 versus 24 weeks, 9.15 ± 4.48 µg/mL, P = 0.004) but not in glycated hemoglobin levels (baseline, 7.7 ± 0.5 versus 24 weeks, 7.4 ± 0.6%, P = 0.100). Body weight remained unchanged. Conclusion:Compared with glimepiride, repaglinide improved 1,5-anhydroglucitol levels but had no effect on glycated hemoglobin. This suggests that repaglinide is a useful option for treating postprandial hyperglycemia.

SUBMITTER: Yamada H

PROVIDER: S-EPMC6188029 | biostudies-other | 2018 Nov

REPOSITORIES: biostudies-other

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Effects of Repaglinide Versus Glimepiride on 1,5-Anhydroglucutol and Glycated Hemoglobin Levels in Japanese Patients With Type 2 Diabetes.

Yamada Hodaka H Kakei Masafumi M Hara Kazuo K

Journal of clinical medicine research 20181009 11

<h4>Background</h4>Postprandial hyperglycemia is a well-known risk factor for cardiovascular disease. We prospectively examined the effects of repaglinide on postprandial hyperglycemia in patients with type 2 diabetes.<h4>Methods</h4>During this 24-week, single-arm, prospective study, we enrolled 10 patients with type 2 diabetes who were previously being administered glimepiride (0.5 or 1 mg/day) and switched it with repaglinide (0.75 or 1.5 mg/day). Changes in their metabolic parameters were ev ...[more]

PMID: 30344819

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Project description:BACKGROUND:Fasting glucose is the standard measure used to diagnose diabetes in the United States. Recently, glycated hemoglobin was also recommended for this purpose. METHODS:We compared the prognostic value of glycated hemoglobin and fasting glucose for identifying adults at risk for diabetes or cardiovascular disease. We measured glycated hemoglobin in whole-blood samples from 11,092 black or white adults who did not have a history of diabetes or cardiovascular disease and who attended the second visit (occurring in the 1990-1992 period) of the Atherosclerosis Risk in Communities (ARIC) study. RESULTS:The glycated hemoglobin value at baseline was associated with newly diagnosed diabetes and cardiovascular outcomes. For glycated hemoglobin values of less than 5.0%, 5.0 to less than 5.5%, 5.5 to less than 6.0%, 6.0 to less than 6.5%, and 6.5% or greater, the multivariable-adjusted hazard ratios (with 95% confidence intervals) for diagnosed diabetes were 0.52 (0.40 to 0.69), 1.00 (reference), 1.86 (1.67 to 2.08), 4.48 (3.92 to 5.13), and 16.47 (14.22 to 19.08), respectively. For coronary heart disease, the hazard ratios were 0.96 (0.74 to 1.24), 1.00 (reference), 1.23 (1.07 to 1.41), 1.78 (1.48 to 2.15), and 1.95 (1.53 to 2.48), respectively. The hazard ratios for stroke were similar. In contrast, glycated hemoglobin and death from any cause were found to have a J-shaped association curve. All these associations remained significant after adjustment for the baseline fasting glucose level. The association between the fasting glucose levels and the risk of cardiovascular disease or death from any cause was not significant in models with adjustment for all covariates as well as glycated hemoglobin. For coronary heart disease, measures of risk discrimination showed significant improvement when glycated hemoglobin was added to models including fasting glucose. CONCLUSIONS:In this community-based population of nondiabetic adults, glycated hemoglobin was similarly associated with a risk of diabetes and more strongly associated with risks of cardiovascular disease and death from any cause as compared with fasting glucose. These data add to the evidence supporting the use of glycated hemoglobin as a diagnostic test for diabetes.

Project description:ImportanceNew-onset diabetes after the age of 50 years is a potential indicator of pancreatic cancer. Understanding the associations between hyperglycemia, diabetes, and pancreatic cancer, including pancreatic ductal adenocarcinoma, is key to developing an approach to early detection.ObjectiveTo assess the association of elevation in glycated hemoglobin (HbA1c) with the risk of pancreatic cancer.Design, setting, and participantsThis cohort study was conducted using data collected from an integrated health care system in California. A total of 851 402 patients aged 50 to 84 years who had HbA1c measurements taken between 2010 and 2014 were identified as the base cohort, with 12 contemporaneous cohorts created based on varying HbA1c thresholds (ie, 6.1%, 6.3%, 6.5%, and 6.7%) and prior diabetes status. Data analysis was conducted from August 2018 to September 2019.Main outcomes and measuresNew cases of pancreatic cancer identified through cancer registry and California death files during a 3-year period. Three-year risk, incidence rate, sensitivity, number of patients needed to screen to detect 1 case, timing, and stage at diagnosis were determined.ResultsAmong 851 402 patients in the base cohort, 447 502 (52.5%) were women, 255 441 (30.0%) were Hispanic participants, 383 685 (45.1%) were non-Hispanic white participants, 100 477 (11.8%) were Asian participants, and 88 969 (10.4%) were non-Hispanic black participants, with a median (interquartile range) age of 62 (56-69) years and a median (interquartile range) HbA1c level of 6.0% (5.7%-6.6%). The incidence rate of pancreatic cancer was 0.45 (95% CI, 0.43-0.49) per 1000 person-years. After excluding prior diabetes as well as confirmation of new-onset hyperglycemia based on an HbA1c level of 6.5%, a total of 20 012 patients remained, with 74 of 1041 pancreatic ductal adenocarcinoma cases (7.1%) from the base cohort included. The rate of pancreatic cancer was 0.72 (95% CI, 0.32-1.42) per 1000 person-years among Asian patients, 0.83 (95% CI, 0.35-1.71) per 1000 person-years among non-Hispanic black patients, 0.84 (95% CI, 0.48-1.37) per 1000 person-years among Hispanic patients, and 2.37 (95% CI, 1.75-3.14) per 1000 person-years among non-Hispanic white patients. Overall, 42 of 74 cancers (56.8%) were diagnosed within 1 year of the index laboratory test. Among 1041 total cases, 708 (68.0%) had staging information available, of whom 465 (65.7%) had stage III or IV disease at diagnosis. In the base cohort, the number needed to undergo evaluation to identify a single case of pancreatic ductal adenocarcinoma was 818 (95% CI, 770-869), with estimates ranging from 206 (95% CI, 160-264) to 600 (95% CI, 540-666) in the subcohorts.Conclusions and relevanceThe findings of this study suggest that screening patients for pancreatic cancer based solely on elevation in HbA1c level is unlikely to represent an effective strategy. Future efforts to identify a high-risk population based on changes in glycemic parameters should account for racial/ethnic differences.

Dataset Information

Effects of Repaglinide Versus Glimepiride on 1,5-Anhydroglucutol and Glycated Hemoglobin Levels in Japanese Patients With Type 2 Diabetes.

Publications

Effects of Repaglinide Versus Glimepiride on 1,5-Anhydroglucutol and Glycated Hemoglobin Levels in Japanese Patients With Type 2 Diabetes.

Similar Datasets

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