Abstract
We retrospectively analyzed the CoDiC® data from 33 institutes in the Japan Diabetes Clinical Data Management Study Group in order to clarify the therapeutic efficacy of DPP-4 inhibitors (DPP-4is) and sulfonylureas (SUs) in Japanese patients with type 2 diabetes who have not previously received pharmacologic treatment. At the end of July in 2015, 498 and 349 patients were treated for more than two years with DPP-4is and SUs, respectively. In comparison to SUs, the DPP-4is group showed a more prominent HbA1c reduction (even in patients with a higher initial HbA1c [<9.0 %]), a higher proportion of patients who continued monotherapy with the initial agent, and a higher proportion of patients with an HbA1c value of <7.0 %. Additional hypoglycemic therapy was administered to 42 % of the patients treated with DPP-4is and 54 % of the patients treated with SUs; this mainly involved biguanide treatment (DPP-4i vs SU; 53 % vs 56 %). Among the DPP-4i-treated patients, weight gain was only observed in the patients with an initial HbA1c value of >10 %, whereas it was observed irrespective of the initial HbA1c value in the SU-treated patients. These results were confirmed by a propensity score matching analysis. In conclusion, these results suggest that DPP-4is show superior therapeutic efficacy to SUs as an insulin secretion promoting agent in the treatment of drug-naive type 2 diabetes patients.
