Time filter

Source Type

PubMed | Eli Lilly and Company, The Study Group of the Diabetes Committee, Kawasaki Saiwai Hospital, Kawasaki Saiwai Clinic and 3 more.
Type: Journal Article | Journal: Diabetes therapy : research, treatment and education of diabetes and related disorders | Year: 2016

Guidelines recommend insulin progression for patients with type 2 diabetes (T2D) with inadequate glycemic control. The Multinational Observational Study Assessing Insulin use (MOSAIc [ClinicalTrials.gov identifier, NCT01400971]) study is a 2-year observational study, investigating factors that influence insulin progression in T2D patients. In this first of two reports, we describe baseline clinical and psychosocial characteristics of Chinese, Japanese, and South Korean patients who participated in MOSAIc. Insulin treatment, factors affecting progression, and outcomes will be reported separately.Patients with T2D using insulin for 3months were eligible. Baseline demographic, clinical, and psychosocial data were collected from patients. Quality of life instruments, including the Diabetes Distress Scale (DDS), were used to assess patients concerns about disease management, support, and emotional burden. The association between the DDS and the selected covariates was also assessed.A total of 373 patients in China, 157 in Japan, and 141 in South Korea were enrolled from July 2011 to July 2013. Meanstandard deviation duration (years) of T2D differed across countries (China 11.47.5; Japan 13.88.7; South Korea 15.78.8; P<0.0001). Japanese patients used more noninsulin anti-hyperglycemic agents than did Chinese or South Korean patients (P<0.0001). Exclusive use of basal insulin was most common in Japan and South Korea compared with China, whereas approximately 66.8% of Chinese patients used mixed insulin. Covariates associated with the DDS were younger age [P=0.044 (Japan)], higher incidence of monthly hypoglycemia [P=0.036 [China]; P=0.021 (South Korea)], and male gender [P=0.037 (South Korea)].There were significant differences amongst East Asian patients with T2D treated with insulin, including in quality of life scores. Results from the MOSAIc longitudinal analyses will further investigate trends of insulin intensification and barriers to insulin progression.Eli Lilly and Company.


Toyoda M.,Tokai University | Suzuki D.,Tokai University | Itou S.,The Study Group of the Diabetes Committee | Matoba K.,The Study Group of the Diabetes Committee | And 3 more authors.
Diabetology International | Year: 2013

Aims: To (1) measure urinary albumin and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus (DM) in Kanagawa Prefecture, (2) assess the validity of the diabetic nephropathy (DN) stage classification system and current chronic kidney disease (CKD) stage classification system from the Kidney Disease Outcomes Quality Initiative-Kidney Disease: Improving Global Outcomes (K/DOQI-KDIGO), and (3) validate the new CKD stage classification system of KIDIGO 2009. Subjects and methods: The Kanagawa Physicians Association conducted a survey across 255 medical institutions over six months and measured urinary creatinine-corrected urinary albumin levels in 4,885 subjects, in addition to height, weight, blood pressure, sex, age, urinalysis, urinary albumin, blood glucose, hemoglobin A1c, and serum creatinine levels. Results: In stages 1 and 2 of the DN classification system, many patients with urinary albumin <300 mg/g Cr had low eGFR. More than 1,000 such cases were unclassifiable. Similarly, many patients had inconsistent urinary albumin levels and eGFRs and thus could not be classified. Using the current CKD stage classification system, 735 patients (15.0 %) were unclassifiable as they had normoalbuminuria with stage 1 renal function, and 1,921 patients (about 40 %) were excluded based on normoalbuminuria with stage 2 renal function. However, all patients were successfully classified by the new CKD stage classification system. Conclusions: All of the patients were successfully classified by the new CKD stage classification system. However, many patients were elderly and hypertensive and thus likely to have diseases other than DN. Regular monitoring of diabetics for urinary albumin and eGFR should enhance the early detection of DN and enable appropriate intervention. © 2012 The Japan Diabetes Society.


Maeda H.,The Study Group of the Diabetes Committee | Kubota A.,The Study Group of the Diabetes Committee | Tanaka Y.,St. Marianna University School of Medicine | Terauchi Y.,Yokohama City University | Matsuba I.,The Study Group of the Diabetes Committee
Diabetes Research and Clinical Practice | Year: 2012

We evaluated the efficacy and safety of sitagliptin after 3 months' treatment in Japanese type 2 diabetic patients and examined changes in clinical factors. Baseline HbA1c, PPG, BMI, and duration of diabetes may be predictors of HbA1c reduction when using sitagliptin in Japanese type 2 diabetic patients. © 2011 Elsevier Ireland Ltd.


Maeda H.,The Study Group of the Diabetes Committee | Kubota A.,The Study Group of the Diabetes Committee | Kanamori A.,The Study Group of the Diabetes Committee | Tanaka Y.,St. Marianna University School of Medicine | And 2 more authors.
Diabetes Research and Clinical Practice | Year: 2015

We found a slight elevation of serum creatinine in the subjects treated with sitagliptin for 2 years and a correlation between creatinine elevation and HbA1c reduction. These results suggest that creatinine elevation is associated with activation of incretin, most possibly with up-regulation of diuretic activity of GLP-1. © 2015 Elsevier Ireland Ltd.


PubMed | The Study Group of the Diabetes Committee, Yokohama City University, Tokai University and St. Marianna University School of Medicine
Type: Journal Article | Journal: Journal of clinical medicine research | Year: 2014

To evaluate the efficacy of switching from insulin to the GLP-1 receptor agonist liraglutide in type 2 diabetes mellitus patients.The subjects were 231 outpatients with type 2 diabetes mellitus being treated with liraglutide for the first time. For 161 patients, liraglutide was continued for 24 weeks (continuation group), and for 70 patients, liraglutide was discontinued before 24 weeks (discontinuation group). Fasting and postprandial blood glucose levels, HbA1c, body weight, and insulin dose were evaluated before the switch to liraglutide (baseline) and at 12 and 24 weeks of administration. Trends in HbA1c and weight were compared at 12 and 24 weeks of administration. Multiple regression analyses were conducted to identify clinical factors predicting a successful switch to liraglutide.Multiple regression analysis with HbA1c as the dependent variable in the continuation group indicated that HbA1c at 12 weeks of administration decreased with higher baseline HbA1c and increased with higher baseline daily insulin doses. Multiple regression analysis with weight as the dependent variable indicated that weight at 24 weeks of liraglutide administration was higher with higher baseline daily insulin doses and longer duration of diabetes. Based on the area under the receiver operating characteristic curve, cut-off values of 19 units for daily insulin dose and nine years for duration of diabetes were identified.Switching from insulin to liraglutide therapy is possible for carefully selected patients. Daily insulin dosage and duration of insulin therapy appear to be clinically useful indicators for the efficacy of liraglutide therapy.


Kubota A.,The Study Group of the Diabetes Committee | Maeda H.,The Study Group of the Diabetes Committee | Kanamori A.,The Study Group of the Diabetes Committee | Matoba K.,The Study Group of the Diabetes Committee | And 26 more authors.
Journal of Diabetes Investigation | Year: 2012

Aims/Introduction: To determine the efficacy and safety of sitagliptin monotherapy and combination therapy in Japanese type2 diabetes patients after 3months' therapy. Materials and Methods: A retrospective, observational study of 741 type2 diabetes patients was carried out; 110 received sitagliptin monotherapy, and 631 received combination therapy with sitagliptin when other oral medications were insufficient. The primary outcome measure was glycated hemoglobin (HbA1c) measured at 0, 4 and 12weeks of sitagliptin therapy. Results: In the monotherapy and combination therapy groups, HbA1c decreased significantly after 12weeks. Target HbA1c (<7%) was achieved in 39.1% overall. On logistic regression analysis, baseline HbA1c was the strongest contributing factor for achieving target HbA1c; baseline body mass index and duration of diabetes were also significant factors. A total of 82 patients (11%) were unresponsive to sitagliptin. These patients' baseline body mass index was significantly higher and their baseline HbA1c was significantly lower than those of patients who responded to sitagliptin. The most commonly co-administered drugs were sulfonylureas (508 patients). In these patients, the dose of sulfonylurea decreased with time. In 66 patients whose sulfonylurea dosage was reduced when sitagliptin was started, HbA1c and bodyweight decreased significantly after 12weeks. A total of 24 patients receiving sulfonylureas had mild hypoglycemia, but none discontinued sitagliptin. Conclusions: Sitagliptin was effective and safe as both monotherapy and combination therapy in Japanese type2 diabetes patients. When sulfonylureas were ineffective, sitagliptin improved glycemic control. In patients whose sulfonylurea dose was reduced at the start of sitagliptin, blood glucose improved and bodyweight decreased after 12weeks. © 2012 Asian Association for the Study of Diabetes and Wiley Publishing Asia Pty Ltd.


PubMed | The Study Group of the Diabetes Committee
Type: Journal Article | Journal: Diabetes research and clinical practice | Year: 2011

We evaluated the efficacy and safety of sitagliptin after 3 months treatment in Japanese type 2 diabetic patients and examined changes in clinical factors. Baseline HbA1c, PPG, BMI, and duration of diabetes may be predictors of HbA1c reduction when using sitagliptin in Japanese type 2 diabetic patients.


PubMed | The Study Group of the Diabetes Committee
Type: Journal Article | Journal: Journal of clinical medicine research | Year: 2012

Sitagliptin is a DPP-4 inhibitor that became available for use in Japan three years ago. This study was conducted to identify the pleiotropic effects of sitagliptin other than blood glucose lowering in Japanese type 2 diabetes mellitus patients.A retrospective, observational study of 940 type 2 diabetes mellitus patients was conducted. The primary outcome measures were HbA1c, blood pressure, and lipid profiles measured at 0, 4, and 12 weeks of sitagliptin therapy.After 12 weeks of sitagliptin treatment, compared with baseline, HbA1c decreased 0.64% 0.86%; systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased significantly; and serum creatinine (Cr) and uric acid (UA) levels were mildly but significantly elevated. A correlation analysis of the changes in systolic blood pressure, diastolic blood pressure, creatinine, and uric acid (SBP, DBP, Cr, UA) from baseline to 12 weeks showed significant negative correlations between SBP and Cr, SBP and UA, and DBP and Cr. Total cholesterol and postprandial triglycerides were significantly decreased at both 4 and 12 weeks. Alkaline phosphatase (ALP) decreased significantly, and there was a significant positive correlation between changes in ALP and HbA1c.Sitagliptin seems to be effective not only in lowering blood glucose but also in lowering blood pressure, lipid, and ALP levels. Sitagliptin appears to contribute to a Na-diuretic action due to GLP-1.


PubMed | The Study Group of the Diabetes Committee, Yokohama City University and St. Marianna University School of Medicine
Type: Journal Article | Journal: Diabetes research and clinical practice | Year: 2014

We retrospectively studied more than 1000 patients with type 2 diabetes attending 36 Japanese clinics to investigate the efficacy and safety of adding sitagliptin to various insulin regimens. We found that the treatment with add-on sitagliptin for 6-months was effective, irrespective of the type or dose of concomitant insulin.

Loading The Study Group of the Diabetes Committee collaborators
Loading The Study Group of the Diabetes Committee collaborators