Earticle

초록

영어

Objective: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. Methods: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin A1c (HbA1c) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for HbA1c values, amounts of HbA1c changes, and rates of HbA1c changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. Results: SU group showed larger HbA1c changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable HbA1c <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable HbA1c <6.5% was not significantly different, but time to achieve stable HbA1c <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. Conclusion: DPP-4 inhibitors were as effective as sulfonylureas in achieving the HbA1c goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.

목차

ABSTRACT
 연구 방법
  대상 환자 및 자료수집
  자료분석
  통계분석
 연구 결과
  대상환자의 특성
  DPP4 저해제군과 SU계열군의 기간별 혈중 HbA1c 수치비교
  DPP4 저해제군과 SU계열군에서 HbA1c반응율 비교
  DPP4 저해제군과 SU계열군의 심뇌혈관계 질환 발생빈도비교
 고찰 및 결론
 참고문헌

키워드

저자

• 박지혜 [ Ji Hye Park | 서울아산병원 약제팀, 이화여자대학교 임상보건과학대학원 ]
• 박선이 [ Sunny Park | 이화여자대학교 약학대학 ]
• 김재연 [ Jae Youn Kim | 서울아산병원 약제팀 ]
• 김주희 [ Joo Hee Kim | 이화여자대학교 약학대학 ] Co-correspondence
• 곽혜선 [ Hye Sun Gwak | 이화여자대학교 임상보건과학대학원, 이화여자대학교 약학대학 ] Corresponding author

참고문헌

발행기관

간행물

표지보기 관심저널 등록

• 간행물명

  한국임상약학회지 [Korean Journal of Clinical Pharmacy]

• 간기

  계간

• pISSN

  1226-6051

• 수록기간

  1991~2026

• 등재여부

  KCI 등재

• 십진분류

  KDC 518 DDC 615