Effect of Switching from Sulphonylurea to Repaglinide Twice or Three Times Daily for 4 Months on Glycemic Control in Japanese Patients with Type 2 Diabetes

Intern Med. 2016;55(13):1697-703. doi: 10.2169/internalmedicine.55.6566. Epub 2016 Jul 1.

Abstract

Objective Switching from sulfonylureas to repaglinide in patients with type 2 diabetes improves glycemic control; however, the optimal dosage has not been fully evaluated. We designed to show that repaglinide was equivalent to sulfonylurea in Japanese patients with type 2 diabetes. We herein evaluated whether we could switch from sulfonylureas to repaglinide twice or thrice daily in Japanese adult patients who had been treated with anti-diabetic drugs, including sulfonylureas, and whose conditions were moderately well-controlled. Methods A total of 78 patients taking less than half the Japanese maximum dose of sulfonylurea were randomized into three groups: 26 in group A (switching from sulfonylureas to taking 0.25 or 0.5 mg of repaglinide just before breakfast and dinner twice daily), 27 in group B (switching from sulfonylureas to taking 0.25 or 0.5 mg of repaglinide just before meals thrice daily), and 25 in group C (continuing to take sulfonylurea). Blood samples were collected at 0, 1, 2, 3, and 4 months following the initiation of the maintenance period. Results The HbA1c and glycoalbumin levels did not significantly differ among the three groups after 4 months of treatment. Conclusion With the assumption that 1 mg of glimepiride is equivalent to 1.25 mg of glibenclamide or 40 mg of gliclazide, the administration of repaglinide (0.44 mg/meal) twice and thrice daily is similar to the efficacy of sulfonylurea (glimepiride 1.63-1.98 mg/day) after four months of treatment in Japanese patients with moderately well-controlled type 2 diabetes (HbA1c, 7-7.5%).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Blood Glucose / drug effects
  • Carbamates / administration & dosage
  • Carbamates / therapeutic use*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Drug Administration Schedule
  • Female
  • Glycated Hemoglobin
  • Glycated Serum Albumin
  • Glycation End Products, Advanced
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Japan
  • Male
  • Middle Aged
  • Piperidines / administration & dosage
  • Piperidines / therapeutic use*
  • Serum Albumin
  • Sulfonylurea Compounds / administration & dosage
  • Sulfonylurea Compounds / therapeutic use*

Substances

  • Blood Glucose
  • Carbamates
  • Glycated Hemoglobin A
  • Glycation End Products, Advanced
  • Hypoglycemic Agents
  • Piperidines
  • Serum Albumin
  • Sulfonylurea Compounds
  • repaglinide
  • Glycated Serum Albumin