Comparison of efficacy of concomitant administration of mitiglinide with voglibose and double dose of mitiglinide in patients with type 2 diabetes mellitus.

UNLABELLED: Aims/Introduction: When monotherapy with an oral hypoglycemic agent (OHA) is not sufficiently effective for blood glucose control, combination therapy with OHA having different mechanisms of action might be indicated. MATERIALS AND METHODS: In the present study, we compared the efficacy of two options in type 2 diabetes mellitus patients whose blood glucose had not been well controlled with mitiglinide (30 mg/day) alone. A total of 20 patients were included in the study and divided into two groups: group A, in which mitiglinide was given concomitantly with the α-glucosidase inhibitor voglibose (0.6 mg/day); and group B, in which a double dose of mitiglinide was given (60 mg/day). Twelve weeks after changing the medication, HbA1c, glycoalbumin and 1,5-anhydroglucitol (1,5-AG) were measured. In addition, at weeks 0 and 12, a meal tolerance test was carried out, and plasma glucose, insulin, glucagon, active glucagon-like peptide-1 (GLP-1) and total glucose-dependent insulinotropic polypeptide levels were measured. RESULTS: The plasma level of 1,5-AG improved in both groups at week 12. In group A, the plasma insulin level significantly decreased and the plasma active GLP-1 level significantly increased during the meal tolerance test at week 12; thus, bodyweight significantly decreased only in group A. CONCLUSIONS: Our findings suggested that concomitant administration of mitiglinide with voglibose could achieve better glycemic control, particularly in the postprandial period, without bodyweight gain and might have beneficial effects in type 2 diabetic patients at risk of macrovascular complications. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2010.0082.x, 2011).

[Teaching of self-monitoring blood glucose to diabetic outpatients].

To improve the guidance for medical care of patients with diabetes, a system for certified diabetes educators in Japan has been started. Self-monitoring of blood glucose is a guidance service conducted for the treatment of diabetes performed by medical technologists. This approach is effective in motivating patients to perform self-control, and guidance that is useful for the improvement of patients' lifestyle as well as instruction of the operation of measurement apparatus is required. To achieve this goal, it is necessary to give a guidance in stages corresponding to the condition of the patient. Medical technologists will be able to participate in team treatment of diabetes by giving such guidance.