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Glycaemic control with add-on thiazolidinedione or a sodium-glucose co-transporter-2 inhibitor in patients with type 2 diabetes after the failure of an oral triple antidiabetic regimen: A 24-week, randomized controlled trial

Authors
 Bae, Jaehyun  ;  Huh, Ji Hye  ;  Lee, Minyoung  ;  Lee, Yong-Ho  ;  Lee, Byung-Wan 
Citation
 DIABETES OBESITY & METABOLISM, Vol.23(2) : 609-618, 2021-02 
Journal Title
 DIABETES OBESITY & METABOLISM 
ISSN
 1462-8902 
Issue Date
2021-02
Keywords
quadruple combination antidiabetic agents ; SGLT2 inhibitor ; thiazolidinedione ; type 2 diabetes
Abstract
Aim To evaluate the effectiveness and safety of adding either a sodium-glucose co-transporter-2 inhibitor (SGLT2i) or thiazolidinedione (TZD) in patients with type 2 diabetes (T2D) inadequately controlled with triple therapy. Materials and Methods In this prospective, open-label, multicentre, 24-week clinical trial, we randomly assigned 119 patients with T2D who failed to achieve glycaemic control (7% < HbA1c <= 10%) with conventional triple oral antidiabetic agents (OADs; metformin, sulphonylurea and dipeptidyl peptide-4 [DPP-4] inhibitor) into two groups who received either an SGLT2i or TZD. The primary endpoint was mean change in HbA1c level between the two groups at 24 weeks. Results In total, 119 patients were enrolled in the SGLT2i (n = 60) and TZD (n = 59) groups. Mean age of the study subjects was 61.86 years, and the mean duration of T2D was 13.89 years. After 24 weeks, both groups showed significant reductions in HbA1c (from 7.94% +/- 0.74% to 6.97% +/- 0.84% in the SGLT2i group and from 8.00% +/- 0.78% to 7.18% +/- 0.98% in the TZD group), without a significant between-group difference (P = .235). A significant body mass index (BMI) reduction was noted in the SGLT2i group, whereas an increase in BMI was noted in the TZD group (-0.79 +/- 1.37 vs. 0.92 +/- 0.86 kg/m(2), P < .001). Other safety profiles were favourable in both groups. Conclusions The current study shows that an SGLT2i or TZD could be a valid option as a fourth OAD for treatment of patients with T2D inadequately controlled with a triple combination of OADs.
DOI
10.1111/dom.14259
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Minyoung(이민영) ORCID logo https://orcid.org/0000-0002-9333-7512
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Huh, Ji Hye(허지혜)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181844
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