초록

Background : Sitagliptin, which inhibits dipeptidyl polypeptidase-4 and stimulate thesecretion of insulin, is primarily used as a combination therapy with other oral hypoglycemicdrugs. Sitagliptin is known to have lower incidence in hypoglycemia compared to other oralhypoglycemic drugs. However, several studies suggest that combination therapy includingsitagliptin, can cause hypoglycemia. The aim of this study is to analyze the effectiveness and thefrequency of hypoglycemia in Korean patients with type 2 diabetes treated with sitagliptin andsulfonylurea. Methods : From August 2008 to April 2010, we retrospectively reviewed the electronic medical records of type 2 diabetes patients who were prescribed sulfonylurea and sitagliptin over a periodof 6 months at Seoul National University Hospital. We excluded patients who had been usinginsulin as well as those, who had ESRD or kidney transplantation. Results : A total of 232 Korean patients were enrolled in this study. The effectiveness in thereduction of blood glucose was statistically significant (P<0.05). In the sulfonylurea maintenancegroup (n=206), 10 patients experienced hypoglycemia, however two of them were not related tothe medicine. In the sulfonylurea reduction group (n=26), one patient who had problems of alcoholabuse, experienced hypoglycemia. Therefore, he recovered from hypoglycemia after quittingdrinking. Conclusions : In this study, the combination therapy of sitagliptin and sulfonylurea significantlyimproved glycemic control. Yet, hypoglycemia occurred in some patients after adding sitagliptin.

키워드

Type 2 DM, Sulfonylurea, Sitagliptin, Hypoglycemia

참고문헌(18)open

  1. [인터넷자료] National Health Insurance Corporation of Korea / National statics of Health insurance of 2010 in South Korea

  2. [학술지] Drab S.R / 2010 / Incretin-based therapies for type 2 diabetes mellitus: current status and future prospects / Pharmacotherapy 30 : 609 ~ 624

  3. [학술지] Gary A. Herman / 2005 / Pharmacokinetics and pharmacodynamics of sitagliptin, an inhibitor of dipeptidyl peptidase IV, in healthy subjects: results from two randomized, double-blind, placebo-controlled studies with single oral doses / Clin Pharmacol 78 (6) : 675 ~ 688

  4. [학술지] Nauck M.A. / 2007 / Efficacy and safety of the dipeptidyl peptidase-4 inhibitor, sitagliptin, compared with the sulfonylurea, glipizide, in patients with type 2 diabetes inadequately controlled on metformin alone: a randomized, double-blind, non-inferiority trial / Diabetes Obes Metab 9 : 194 ~ 205

  5. [학술지] Hermansen K. / 2007 / Efficacy and safety of the dipeptidyl peptidase-4 inhibitor, sitagliptin, in patients with type 2 diabetes mellitus inadequately controlled on glimepiride alone or on glimepiride and metformin / Diabetes Obesity and Metabolism 9 : 733 ~ 745

  6. [학술지] Whitley H.P / 2008 / Hypoglycemia associated with off-label sitagliptin use / International Medical Case Reports Journal 1 : 3 ~ 5

  7. [인터넷자료] / Januvia Insertion Paper

  8. [학술지] Guettier J.M / 2006 / Hypoglycemia / Endocrinology and Metabolism Clinics of North America 35 (4) : 753 ~ 766

  9. [학술지] Raz I. / 2006 / Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin as monotherapy in patients with type 2 diabetes mellitus / Diabetologia 49 : 2564 ~ 2571

  10. [인터넷자료] Japanese diabetes association / Proper use of incretin and sulfonylurea drug

  11. [학술지] Sato D. / 2013 / Effects of a sitagliptin safety alert on prescription behaviour for oral antihyperglycaemic drugs: a propensity score-matched cohort study of prescription receipt data in Japan / Drug Saf 36 (8) : 605 ~ 615

  12. [학술지] Takahara M / 2012 / Efficacy of sitagliptin on blood glucose fluctuation in Japanese type 2 diabetic patients with basal-supported oral therapy / Endocr J. 59 (12) : 1131 ~ 1136

  13. [인터넷자료] / JANUVIA 25mg, 50mg, 100mg film-coated tablets

  14. [인터넷자료] / http://www.msdkorea.com/assets/pdf/products/JANUVIA.pdf

  15. [학술지] Krepinsky J. / 2000 / Prolonged sulfonylurea-induced hypoglycemia in diabetic patients with endstage renal disease / Am J Kidney Dis 35 (3) : 500 ~ 505

  16. [학술지] Raz I. / 2008 / Efficacy and safety of sitagliptin added to ongoing metformin therapy in patients with type 2 diabetes / Current Medical Research and Opinion 24 (2) : 537 ~ 550

  17. [학술지] Currie C.J / 2010 / Survival as a function of HbA1C in people with type 2 diabetes: a retrospective cohort study / The Lancet 375 : 481 ~ 489

  18. [인터넷자료] / Lexicomp online