제 2형 당뇨 환자에서 Sitagliptin과 Sulfonylurea계 약물 병용 시혈당 조절 효과와 저혈당 발현에 관한 연구

Abstract

Background : Sitagliptin, which inhibits dipeptidyl polypeptidase-4 and stimulate thesecretion of insulin, is primarily used as a combination therapy with other oral hypoglycemicdrugs. Sitagliptin is known to have lower incidence in hypoglycemia compared to other oralhypoglycemic drugs. However, several studies suggest that combination therapy includingsitagliptin, can cause hypoglycemia. The aim of this study is to analyze the effectiveness and thefrequency of hypoglycemia in Korean patients with type 2 diabetes treated with sitagliptin andsulfonylurea. Methods : From August 2008 to April 2010, we retrospectively reviewed the electronic medical records of type 2 diabetes patients who were prescribed sulfonylurea and sitagliptin over a periodof 6 months at Seoul National University Hospital. We excluded patients who had been usinginsulin as well as those, who had ESRD or kidney transplantation. Results : A total of 232 Korean patients were enrolled in this study. The effectiveness in thereduction of blood glucose was statistically significant (P<0.05). In the sulfonylurea maintenancegroup (n=206), 10 patients experienced hypoglycemia, however two of them were not related tothe medicine. In the sulfonylurea reduction group (n=26), one patient who had problems of alcoholabuse, experienced hypoglycemia. Therefore, he recovered from hypoglycemia after quittingdrinking. Conclusions : In this study, the combination therapy of sitagliptin and sulfonylurea significantlyimproved glycemic control. Yet, hypoglycemia occurred in some patients after adding sitagliptin.