Abstract
Aim
We aimed to investigate the association of difference between observed and predicted
glycated hemoglobin (dopHbA1c) and HbA1c reduction after vildagliptin-based oral therapy
in patients with type 2 diabetes (T2D).
Methods
This was a prospective observational study. Adults ≥ 20 years old with T2D and HbA1c
≧7% treated with oral anti-diabetic drugs (OADs) were eligible if their OADs were
shifted to vildagliptin-based dual oral therapy. Fasting plasma glucose (FPG) and
HbA1c were recorded at baseline, week 12, and week 24. To determine baseline dopHbA1c,
a predicted HbA1c was calculated by inserting baseline FPG into a regression equation
(HbA1c = FPG ∗ 0.0225 + 4.3806) developed from linear relationship between HbA1c and
FPG in an independent cohort of 3239 outpatients with T2D (dopHbA1c = observed HbA1c
– predicted HbA1c). Patients were assigned to low (≦0) or high (>0) dopHbA1c group
according to their baseline dopHbA1c levels. The study endpoint was changes from baseline
to week 24 in HbA1c levels.
Results
A total of 1224 patients were enrolled. Patients with a dopHbA1c >0 had a greater
HbA1c reduction after vildagliptin-based dual oral therapy than those with a dopHbA1c
≦0 (−1.5 ± 2.0 vs. −0.4 ± 1.0%, p < 0.001). Baseline dopHbA1c was positively associated
with HbA1c reduction from baseline to week 24 (β coefficient 0.883, 95% CI 0.811 to
0.955, p < 0.001), and the association remained significant after adjustment for confounders.
Conclusions
In T2D patients with an HbA1c ≧7%, a higher baseline dopHbA1c was associated with
a greater HbA1c reduction after shifting to vildagliptin-based dual oral therapy.
Keywords
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Article info
Publication history
Published online: February 11, 2018
Accepted:
February 1,
2018
Received in revised form:
December 22,
2017
Received:
October 15,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
