DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20184840

Comparative study of safety and efficacy profile of repaglinide and voglibose on targeting post prandial hyperglycemia in patients with newly diagnosed type II diabetes mellitus

Jyoti Bobde, Rajesh Kadam, Deepak Bhosle

Abstract


Background: In India the number of people with diabetes is increasing day-by-day. Due to a sole “Asian Indian Phenotype,” Indians develop diabetes an era earlier and have an earlier onset of complications. Therefore, it is essential to evaluate more effective treatment strategies at an earlier stage of disease progression.

Methods: The present study was prospective, open label, comparative, randomized, parallel group, single center study. Comparison of two post prandial active treatment groups over a period of 3 months. Sixty patients of either sex in the age group of 30-60years with newly diagnosed type II diabetes mellitus, with prandial blood glucose levels >180mg% and <250mg% at screening as per ADA. The effect of repaglinide and voglibose were observed on various parameters i.e. HbA1c, FBS, PBS, BMI.

Results: In repaglinide group the mean change in HbA1c from baseline to 3 months was 8.05 to 7.04 (-1.01); on the other hand, in voglibose group from baseline to 3 months was 8.0 to 7.18 (-0.82). Whereas, FBS from 137.57 to 122.90 (-16.67) in repaglinide group; in voglibose group from 139.87 to 125.13 (-14.74). Repaglinide statistically highly significant than voglibose group in improving glycemic indices.

Conclusions: Though repaglinide and voglibose were equally effective in improving glycemic indices yet repaglinide showed better results in improving HbA1c, FBG, PBS as compared with voglibose. Repaglinide had minimal side effects as compared to voglibose.


Keywords


Repaglinide, Type II diabetes mellitus, Voglibose

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References


Zimmet PZ. Diabetes epidemiology as a tool to trigger diabetes research and care. Diabetologia. 1999 Apr 1;42(5):499-518.

Boden G. Fatty acids and insulin resistance. Diabetes Care. 2010 Oct; 33(10):394-5.

International Diabetes Federation Atlas. 6th ed. 2014.

American Diabetes Association. postprandial blood glucose. Diabetes Care. 2001 Apr;24(4):775-8.

Avignon A, Radauceanu A, Monnier L. Nonfasting plasma glucose is a better marker of diabetic control than fasting plasma glucose in type 2 diabetes. Diabetes care. 1997 Dec 1;20(12):1822-6.

Adiyodi JR. Acarbose: Revolutionising treatment of NIDDM. Diabetes update. 1999 Jun:18-31.

Ikeda H, Horii S, Matsuo T. Diabetes Res. Clin Pract 1985;(Suppl.):661.

Shinozaki K, Suzuki M, Ikebuchi M, Hirose J, Harano Y, Harano Y. Improvement of insulin sensitivity and dyslipidemia with a new α-glucosidase inhibitor, voglibose, in nondiabetic hyperinsulinemic subjects. Metabolism Clin Experimental. 1996 Jun 1;45(6):731-7.

Landgraf R. Meglitinide analogues in the treatment of type 2 diabetes mellitus. Drugs Aging. 2000 Nov 1;17(5):411-25.

Maitra A, Abbas AK. Endocrine system. In: Kumar V, Fausto N, Abbas AK (eds). Robbins and Cotran Pathologic basis of disease. 7th ed. Philadelphia, Saunders;2005:1156-1226.

Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012;35:1364-79.

UKPDS. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131): 837-853.

Avignon A, Radauceanu A, Monnier L. Nonfasting plasma glucose is a better marker of diabetic control than fasting plasma glucose in type 2 diabetes. Diabetes Care. 1997 Dec 1;20(12):1822-6.

Hanefeld M, Fischer S, Julius U, Schulze J, Schwanebeck U, Schmechel H, et al. Risk factors for myocardial infarction and death in newly detected NIDDM: the diabetes intervention study, 11-year follow-up. Diabetologia. 1996 Nov 1;39(12):1577-83.

Nihalani KP, Shembalkar JP. New modalities in treatment of diabetes. Diabetes Update. 1999:12-17.

Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2009 Jan 1;32(1):193-203.

Gerich JE. Clinical significance, pathogenesis, and management of postprandial hyperglycemia. Arch Internal Med. 2003 Jun 9;163(11):1306-16.

Hu S, Wang S, Fanelli B, Bell PA, Dunning BE, Geisse S, et al. Pancreatic β-cell K ATP channel activity and membrane-binding studies with nateglinide: a comparison with sulfonylureas and repaglinide. J Pharmacol Experimental Therapeut. 2000 May 1;293(2):444-52.

Rosenstock J, Hassman DR, Madder RD, Brazinsky SA, Farrell J, Khutoryansky N, et al. Repaglinide versus nateglinide monotherapy: a randomized, multicenter study. Diabetes Care. 2004 Jun 1;27(6):1265-70.

Ma J, Liu LY, Wu PH, Liao Y, Tao T, Liu W. Comparison of metformin and repaglinide monotherapy in the treatment of new onset type 2 diabetes mellitus in China. J Diabetes Res. 2014;2014.

Fang F, Gon Y, Lj C, Li J, Tian H, Huang W, et al. Comparison of repaglinide and metformin monotherapy as an initial therapy in Chinese patients with newly diagnosed type 2 diabetes mellitus. Eur J Endocrinol. 2014 Jun;170(6):901-8.

Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care 1992. Jul;15(7):815-9.

Goldberg RB, Einhorn D, Lucas CP, Rendell MS, Damsbo P, Huang WC, et al. A randomized placebo-controlled trial of repaglinide in the treatment of type 2 diabetes. Diabetes Care. 1998 Nov 1;21(11):1897-903.

Lee MY, Choi DS, Lee MK, Lee HW, Park TS, Kim DM, et al. Comparison of acarbose and voglibose in diabetes patients who are inadequately controlled with basal insulin treatment: randomized, parallel, open-label, active-controlled study. J Korean Med Sci. 2014 Jan 1;29(1):90-7.

Hitoshi S, Naeao M, jjarada T, Nakajima Y, Inagaki K, Okaiima F. et al. Comparison of three a-glucosidase inhibitors for glycemic control and bodyweight reduction in Japanese patients with obese type 2 diabetes. J Diabetes lnvestig. 2014 Mar23;5(2):206-12.

Guay DR. Repaglinide, a novel, short‐acting hypoglycemic agent for type 2 diabetes mellitus. Pharmacotherapy: J Human Pharmacol Drug Therapy. 1998 Nov 12;18(6):1195-204.

Fujisawa T, Ikegami H, Inoue K, Kawabata Y, Ogihara T. Effect of two α-glucosidase inhibitors, voglibose and acarbose, on postprandial hyperglycemia correlates with subjective abdominal symptoms. Metabolism. 2005 Mar 1;54(3):387-90.