Difference between observed and predicted glycated hemoglobin at baseline and treatment response to vildagliptin-based dual oral therapy in patients with type 2 diabetes
Journal
Diabetes Research and Clinical Practice
Journal Volume
138
Pages
119-127
Date Issued
2018
Author(s)
Abstract
Aim: We aimed to investigate the association of difference between observed and predicted glycated hemoglobin (dopHbA1c) and HbA1c reduction after vildagliptin-based oral therapy in patients with type 2 diabetes (T2D). Methods: This was a prospective observational study. Adults ? 20 years old with T2D and HbA1c ≧7% treated with oral anti-diabetic drugs (OADs) were eligible if their OADs were shifted to vildagliptin-based dual oral therapy. Fasting plasma glucose (FPG) and HbA1c were recorded at baseline, week 12, and week 24. To determine baseline dopHbA1c, a predicted HbA1c was calculated by inserting baseline FPG into a regression equation (HbA1c = FPG ? 0.0225 + 4.3806) developed from linear relationship between HbA1c and FPG in an independent cohort of 3239 outpatients with T2D (dopHbA1c = observed HbA1c – predicted HbA1c). Patients were assigned to low (≦0) or high (>0) dopHbA1c group according to their baseline dopHbA1c levels. The study endpoint was changes from baseline to week 24 in HbA1c levels. Results: A total of 1224 patients were enrolled. Patients with a dopHbA1c >0 had a greater HbA1c reduction after vildagliptin-based dual oral therapy than those with a dopHbA1c ≦0 (?1.5 ± 2.0 vs. ?0.4 ± 1.0%, p < 0.001). Baseline dopHbA1c was positively associated with HbA1c reduction from baseline to week 24 (β coefficient 0.883, 95% CI 0.811 to 0.955, p < 0.001), and the association remained significant after adjustment for confounders. Conclusions: In T2D patients with an HbA1c ≧7%, a higher baseline dopHbA1c was associated with a greater HbA1c reduction after shifting to vildagliptin-based dual oral therapy. ? 2018 Elsevier B.V.
Subjects
Dipeptidyl peptidase-4 inhibitors; Glycated hemoglobin; Hemoglobin glycation index; Type 2 diabetes; Vildagliptin
SDGs
Other Subjects
2,4 thiazolidinedione derivative; hemoglobin A1c; metformin; oral antidiabetic agent; sulfonylurea; vildagliptin; adamantane; antidiabetic agent; dipeptidyl peptidase IV inhibitor; glycosylated hemoglobin; nitrile; pyrrolidine derivative; vildagliptin; adult; age distribution; Article; controlled study; disease duration; female; glucose blood level; human; major clinical study; male; non insulin dependent diabetes mellitus; observational study; open study; population research; prediction; prospective study; sex difference; treatment duration; treatment outcome; treatment response; analogs and derivatives; blood; metabolism; middle aged; Adamantane; Diabetes Mellitus, Type 2; Dipeptidyl-Peptidase IV Inhibitors; Female; Glycated Hemoglobin A; Humans; Hypoglycemic Agents; Male; Middle Aged; Nitriles; Prospective Studies; Pyrrolidines; Treatment Outcome
Publisher
Elsevier Ireland Ltd
Type
journal article