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학술저널
저자정보
김혜진 (아주대학교) 정인경 (강동경희대학교병원) 허규연 (성균관대학교) 김수경 (차의과학대학교) 노정현 (인제대학교) 전성완 (순천향대학교) 강은석 (연세대학교) 이은정 (성균관대학교) 최성희 (서울대학교)
저널정보
대한당뇨병학회 Diabetes and Metabolism Journal Diabetes and Metabolism Journal Vol.46 No.5
발행연도
2022.9
수록면
689 - 700 (12page)
DOI
10.4093/dmj.2021.0183

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Background: The choice of an optimal oral hypoglycemic agent in the initial treatment periods for type 2 diabetes mellitus (T2DM) patients remains difficult and deliberate. We compared the efficacy and safety of glimepiride (GLIM), alogliptin (ALO), and alogliptin-pioglitazone (ALO-PIO) in poorly controlled T2DM patients with drug-naive or metformin failure.Methods: In this three-arm, multicenter, open-label, randomized, controlled trial, poorly controlled T2DM patients were randomized to receive GLIM (<i>n</i>=35), ALO (<i>n</i>=31), or ALO-PIO (<i>n</i>=33) therapy for 24 weeks. The primary endpoint was change in the mean glycosylated hemoglobin (HbA1c) levels at week 24 from baseline. Secondary endpoints were changes in HbA1c level at week 12 from baseline, fasting plasma glucose (FPG) levels, lipid profiles at weeks 12 and 24, and parameters of glycemic variability, assessed by continuous glucose monitoring for 24 weeks.Results: At weeks 12 and 24, the ALO-PIO group showed significant reduction in HbA1c levels compared to the ALO group (?0.96%±0.17% vs. ?0.37%±0.17% at week 12; ?1.13%±0.19% vs. ?0.18%±0.2% at week 24). The ALO-PIO therapy caused greater reduction in FPG levels and significant increase in high-density lipoprotein cholesterol levels at weeks 12 and 24 than the ALO therapy. Compared to low-dose GLIM therapy, ALO-PIO therapy showed greater improvement in glycemic variability. The adverse events were similar among the three arms.Conclusion: ALO-PIO combination therapy during the early period exerts better glycemic control than ALO monotherapy and excellency in glycemic variability than low-dose sulfonylurea therapy in uncontrolled, drug-naive or metformin failed T2DM patients.

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