Comparative Effects of Metformin and Dipeptidyl Peptidase-4 Inhibitors in Japanese Obese Patients with Type 2 Diabetes: A Claims Database Study
Introduction Metformin has demonstrated favorable effects on glycemic control in patients with type 2 diabetes (T2D), regardless of the body mass index (BMI). On the contrary, dipeptidyl peptidase-4 inhibitors (DPP-4is) are reportedly less effective in patients having high BMI values (≥ 25 or ≥ 30)....
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Published in: | Diabetes therapy 2021-08, Vol.12 (8), p.2165-2177 |
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description | Introduction
Metformin has demonstrated favorable effects on glycemic control in patients with type 2 diabetes (T2D), regardless of the body mass index (BMI). On the contrary, dipeptidyl peptidase-4 inhibitors (DPP-4is) are reportedly less effective in patients having high BMI values (≥ 25 or ≥ 30). The aim of this study was to compare metformin and DPP-4is as first-line treatment for their effects on glycemic control and improvement of other health outcomes among obese and non-obese Japanese patients with T2D.
Methods
A Japanese health insurance claims database that also included annual medical checkup data was used. This database included data on company employees who were members of health insurance societies and their family members. Most patients were aged 6.5%; primary outcome) and changes in fasting plasma glucose, BMI, triglyceride, cholesterol, and abdominal circumference (secondary outcomes) at 12 months from baseline were compared between treatments.
Results
When evaluated relative to the baseline BMI, the mean reduction rate in excessive HbA1c tended to be higher in the metformin group than in the DPP-4i group, especially in patients with BMI ≥ 25. Similarly, significant improvement was observed in most outcomes in obese patients prescribed metformin compared to those prescribed a DPP-4i. In contrast, in patients with BMI |
doi_str_mv | 10.1007/s13300-021-01101-2 |
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Metformin has demonstrated favorable effects on glycemic control in patients with type 2 diabetes (T2D), regardless of the body mass index (BMI). On the contrary, dipeptidyl peptidase-4 inhibitors (DPP-4is) are reportedly less effective in patients having high BMI values (≥ 25 or ≥ 30). The aim of this study was to compare metformin and DPP-4is as first-line treatment for their effects on glycemic control and improvement of other health outcomes among obese and non-obese Japanese patients with T2D.
Methods
A Japanese health insurance claims database that also included annual medical checkup data was used. This database included data on company employees who were members of health insurance societies and their family members. Most patients were aged < 65 years and most were men. Inclusion criteria were: (1) a first T2D diagnosis between May 2010 and June 2017; (2) either metformin or a DPP-4i prescribed as the first-line antidiabetic therapy; and (3) glycated hemoglobin (HbA1c) and BMI data available for the 3-month period immediately preceding the initiation of antidiabetic treatment (baseline). The reduction rate in excessive HbA1c (> 6.5%; primary outcome) and changes in fasting plasma glucose, BMI, triglyceride, cholesterol, and abdominal circumference (secondary outcomes) at 12 months from baseline were compared between treatments.
Results
When evaluated relative to the baseline BMI, the mean reduction rate in excessive HbA1c tended to be higher in the metformin group than in the DPP-4i group, especially in patients with BMI ≥ 25. Similarly, significant improvement was observed in most outcomes in obese patients prescribed metformin compared to those prescribed a DPP-4i. In contrast, in patients with BMI < 25, HbA1c reduction was greater in patients prescribed DPP-4i and fewer outcomes showed significant improvement in patients prescribed metformin.
Conclusion
In obese Japanese patients with T2D, greater improvements in glycemic control and other outcomes were seen with metformin as first-line treatment for T2D compared with DPP-4is, although some limitations regarding the database information should be considered.</description><identifier>ISSN: 1869-6953</identifier><identifier>EISSN: 1869-6961</identifier><identifier>DOI: 10.1007/s13300-021-01101-2</identifier><identifier>PMID: 34218420</identifier><language>eng</language><publisher>Cheshire: Springer Healthcare</publisher><subject>Antidiabetics ; Body mass index ; Cardiology ; Comparative analysis ; Diabetes ; Drug therapy ; Endocrinology ; Hypoglycemic agents ; Internal Medicine ; Medicine ; Medicine & Public Health ; Original Research ; Overweight persons ; Patient outcomes ; Type 2 diabetes</subject><ispartof>Diabetes therapy, 2021-08, Vol.12 (8), p.2165-2177</ispartof><rights>The Author(s) 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-bca2aeece0ddaa700bb4bcfaf6a2b83f2eed148ea5374ef2b8f23e42d36de8823</citedby><cites>FETCH-LOGICAL-c479t-bca2aeece0ddaa700bb4bcfaf6a2b83f2eed148ea5374ef2b8f23e42d36de8823</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2938153028/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2938153028?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25731,27901,27902,36989,36990,44566,53766,53768,75096</link.rule.ids></links><search><creatorcontrib>Odawara, Masato</creatorcontrib><creatorcontrib>Aoi, Sumiko</creatorcontrib><creatorcontrib>Takeshima, Tomomi</creatorcontrib><creatorcontrib>Iwasaki, Kosuke</creatorcontrib><title>Comparative Effects of Metformin and Dipeptidyl Peptidase-4 Inhibitors in Japanese Obese Patients with Type 2 Diabetes: A Claims Database Study</title><title>Diabetes therapy</title><addtitle>Diabetes Ther</addtitle><description>Introduction
Metformin has demonstrated favorable effects on glycemic control in patients with type 2 diabetes (T2D), regardless of the body mass index (BMI). On the contrary, dipeptidyl peptidase-4 inhibitors (DPP-4is) are reportedly less effective in patients having high BMI values (≥ 25 or ≥ 30). The aim of this study was to compare metformin and DPP-4is as first-line treatment for their effects on glycemic control and improvement of other health outcomes among obese and non-obese Japanese patients with T2D.
Methods
A Japanese health insurance claims database that also included annual medical checkup data was used. This database included data on company employees who were members of health insurance societies and their family members. Most patients were aged < 65 years and most were men. Inclusion criteria were: (1) a first T2D diagnosis between May 2010 and June 2017; (2) either metformin or a DPP-4i prescribed as the first-line antidiabetic therapy; and (3) glycated hemoglobin (HbA1c) and BMI data available for the 3-month period immediately preceding the initiation of antidiabetic treatment (baseline). The reduction rate in excessive HbA1c (> 6.5%; primary outcome) and changes in fasting plasma glucose, BMI, triglyceride, cholesterol, and abdominal circumference (secondary outcomes) at 12 months from baseline were compared between treatments.
Results
When evaluated relative to the baseline BMI, the mean reduction rate in excessive HbA1c tended to be higher in the metformin group than in the DPP-4i group, especially in patients with BMI ≥ 25. Similarly, significant improvement was observed in most outcomes in obese patients prescribed metformin compared to those prescribed a DPP-4i. In contrast, in patients with BMI < 25, HbA1c reduction was greater in patients prescribed DPP-4i and fewer outcomes showed significant improvement in patients prescribed metformin.
Conclusion
In obese Japanese patients with T2D, greater improvements in glycemic control and other outcomes were seen with metformin as first-line treatment for T2D compared with DPP-4is, although some limitations regarding the database information should be considered.</description><subject>Antidiabetics</subject><subject>Body mass index</subject><subject>Cardiology</subject><subject>Comparative analysis</subject><subject>Diabetes</subject><subject>Drug therapy</subject><subject>Endocrinology</subject><subject>Hypoglycemic agents</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Research</subject><subject>Overweight persons</subject><subject>Patient outcomes</subject><subject>Type 2 diabetes</subject><issn>1869-6953</issn><issn>1869-6961</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNp9ks9u1DAQxiMEolXpC3CyxIVLwP-SOByQVtsCRUWtRDlb42S86yqJg-0U7VPwyni7VSs44IM9sr_5eWb0FcVrRt8xSpv3kQlBaUk5KyljlJX8WXHMVN2WdVuz549xJY6K0xhvaV6ibVvGXhZHQnKmJKfHxe-1H2cIkNwdknNrsUuReEu-YbI-jG4iMPXkzM04J9fvBnJ9H0DEUpKLaeuMSz5EkoVfYYYJI5Irs9-vMxOnTPvl0pbc7GYkPIPAYML4gazIegA3RnIGCUzmke9p6XevihcWhoinD-dJ8ePT-c36S3l59flivbosO9m0qTQdcEDskPY9QEOpMdJ0FmwN3ChhOWLPpEKoRCPR5jvLBUrei7pHpbg4KT4euPNiRuy7XGmAQc_BjRB22oPTf79Mbqs3_k6rPLtGsAx4-wAI_ueCMenRxQ6HIc_AL1HzSqqay6qhWfrmH-mtX8KU29O8FYpVgnL1pNrAgNpN1ud_uz1Ur-qGtk0jK5lV_KDqgo8xoH0smVG9N4Y-GENnY-h7Y-h9s-KQFLN42mB4KuA_WX8AnKS7Ig</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Odawara, Masato</creator><creator>Aoi, Sumiko</creator><creator>Takeshima, Tomomi</creator><creator>Iwasaki, Kosuke</creator><general>Springer Healthcare</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210801</creationdate><title>Comparative Effects of Metformin and Dipeptidyl Peptidase-4 Inhibitors in Japanese Obese Patients with Type 2 Diabetes: A Claims Database Study</title><author>Odawara, Masato ; Aoi, Sumiko ; Takeshima, Tomomi ; Iwasaki, Kosuke</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-bca2aeece0ddaa700bb4bcfaf6a2b83f2eed148ea5374ef2b8f23e42d36de8823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antidiabetics</topic><topic>Body mass index</topic><topic>Cardiology</topic><topic>Comparative analysis</topic><topic>Diabetes</topic><topic>Drug therapy</topic><topic>Endocrinology</topic><topic>Hypoglycemic agents</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Research</topic><topic>Overweight persons</topic><topic>Patient outcomes</topic><topic>Type 2 diabetes</topic><toplevel>online_resources</toplevel><creatorcontrib>Odawara, Masato</creatorcontrib><creatorcontrib>Aoi, Sumiko</creatorcontrib><creatorcontrib>Takeshima, Tomomi</creatorcontrib><creatorcontrib>Iwasaki, Kosuke</creatorcontrib><collection>Springer_OA刊</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Odawara, Masato</au><au>Aoi, Sumiko</au><au>Takeshima, Tomomi</au><au>Iwasaki, Kosuke</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative Effects of Metformin and Dipeptidyl Peptidase-4 Inhibitors in Japanese Obese Patients with Type 2 Diabetes: A Claims Database Study</atitle><jtitle>Diabetes therapy</jtitle><stitle>Diabetes Ther</stitle><date>2021-08-01</date><risdate>2021</risdate><volume>12</volume><issue>8</issue><spage>2165</spage><epage>2177</epage><pages>2165-2177</pages><issn>1869-6953</issn><eissn>1869-6961</eissn><abstract>Introduction
Metformin has demonstrated favorable effects on glycemic control in patients with type 2 diabetes (T2D), regardless of the body mass index (BMI). On the contrary, dipeptidyl peptidase-4 inhibitors (DPP-4is) are reportedly less effective in patients having high BMI values (≥ 25 or ≥ 30). The aim of this study was to compare metformin and DPP-4is as first-line treatment for their effects on glycemic control and improvement of other health outcomes among obese and non-obese Japanese patients with T2D.
Methods
A Japanese health insurance claims database that also included annual medical checkup data was used. This database included data on company employees who were members of health insurance societies and their family members. Most patients were aged < 65 years and most were men. Inclusion criteria were: (1) a first T2D diagnosis between May 2010 and June 2017; (2) either metformin or a DPP-4i prescribed as the first-line antidiabetic therapy; and (3) glycated hemoglobin (HbA1c) and BMI data available for the 3-month period immediately preceding the initiation of antidiabetic treatment (baseline). The reduction rate in excessive HbA1c (> 6.5%; primary outcome) and changes in fasting plasma glucose, BMI, triglyceride, cholesterol, and abdominal circumference (secondary outcomes) at 12 months from baseline were compared between treatments.
Results
When evaluated relative to the baseline BMI, the mean reduction rate in excessive HbA1c tended to be higher in the metformin group than in the DPP-4i group, especially in patients with BMI ≥ 25. Similarly, significant improvement was observed in most outcomes in obese patients prescribed metformin compared to those prescribed a DPP-4i. In contrast, in patients with BMI < 25, HbA1c reduction was greater in patients prescribed DPP-4i and fewer outcomes showed significant improvement in patients prescribed metformin.
Conclusion
In obese Japanese patients with T2D, greater improvements in glycemic control and other outcomes were seen with metformin as first-line treatment for T2D compared with DPP-4is, although some limitations regarding the database information should be considered.</abstract><cop>Cheshire</cop><pub>Springer Healthcare</pub><pmid>34218420</pmid><doi>10.1007/s13300-021-01101-2</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Antidiabetics Body mass index Cardiology Comparative analysis Diabetes Drug therapy Endocrinology Hypoglycemic agents Internal Medicine Medicine Medicine & Public Health Original Research Overweight persons Patient outcomes Type 2 diabetes |
title | Comparative Effects of Metformin and Dipeptidyl Peptidase-4 Inhibitors in Japanese Obese Patients with Type 2 Diabetes: A Claims Database Study |
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