Predictive Factors for Efficacy of Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes Mellitus

BACKGROUND: Predictive factors for the efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors for lowering glycosylated hemoglobin (HbA1c) remain unclear in patients with type 2 diabetes mellitus. The aim of this study is therefore to clarify predictive factors of the efficacy of DPP-4 inhibitors for lowering HbA1c after 12 months of treatment. METHODS: A total of 191 consecutive type 2 diabetic patients (male sex 55%, mean age, 68.3+/-35.8 years), who had been treated with DPP-4 inhibitors for 12 months, were enrolled in this study and evaluated retrospectively. RESULTS: After 12 months of DPP-4 inhibitor treatment, random blood glucose level, and HbA1c level, decreased from 167+/-63 to 151+/-49 mg/dL (P<0.01), and from 7.5%+/-1.3% to 6.9%+/-0.9% (P<0.01) respectively, without severe side effects. Multiple regression analysis showed that predictors of DPP-4 inhibitor treatment efficacy in lowering HbA1c level after 12 months were a decrease in HbA1c level after 3 months of treatment, a high baseline HbA1c level, a low baseline body mass index, and the absence of coronary artery disease. CONCLUSION: Most suitable candidates for treatment with DPP-4 inhibitors are diabetics who are not obese and do not have coronary artery disease. In addition, long-term efficacy of DPP-4 inhibitors can be predicted by decrement of HbA1c after 3 months of treatment.

Effects of a Combination of Wooden Interior and Indirect Lighting in the Bedroom on Improving Sleep Quality and Attenuating Fatigue / 日本補完代替医療学会誌

Objective: We conducted a clinical study to investigate the effects of a combination of wooden interior and indirect lighting in the bedroom on improving sleep quality and attenuating fatigue. Design: Eleven healthy male subjects, whose Pittsburgh Sleep Quality Index (PSQI) scores were ≥ 6, participated in a 3-way crossover trial. Subjects rested from 21:00 to 22:00 under a combination of wooden interior and indirect lighting, indirect lighting, or direct lighting, went to bed at 22:00, and awoke at 6:00. We evaluated sleep quality by the St. Mary's Hospital Sleep Questionnaire (SMHSQ), autonomic nervous function by the Active Tracer, sleepiness and fatigue sensation by the Visual Analogue Scale (VAS), and performance by the Advanced Trail Making Test (ATMT). Results: The combination of wooden interior and indirect lighting improved early morning awakening, nocturnal awakening, and satisfaction with sleep according to the SMHSQ, activated the parasympathetic nerve system at bedtime according to the Active Tracer, and attenuated sleepiness and fatigue sensation at the time of awakening according to the VAS; moreover, it improved work performance according to the ATMT. Conclusion: These results show that the combination of wooden interior and indirect lighting produces a suitable bedroom environment that improves sleep quality and attenuates fatigue.