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)....

Full description

Saved in:
Bibliographic Details
Published in:Diabetes therapy 2021-08, Vol.12 (8), p.2165-2177
Main Authors: Odawara, Masato, Aoi, Sumiko, Takeshima, Tomomi, Iwasaki, Kosuke
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c479t-bca2aeece0ddaa700bb4bcfaf6a2b83f2eed148ea5374ef2b8f23e42d36de8823
cites cdi_FETCH-LOGICAL-c479t-bca2aeece0ddaa700bb4bcfaf6a2b83f2eed148ea5374ef2b8f23e42d36de8823
container_end_page 2177
container_issue 8
container_start_page 2165
container_title Diabetes therapy
container_volume 12
creator Odawara, Masato
Aoi, Sumiko
Takeshima, Tomomi
Iwasaki, Kosuke
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
format article
fullrecord <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8342731</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A670977454</galeid><sourcerecordid>A670977454</sourcerecordid><originalsourceid>FETCH-LOGICAL-c479t-bca2aeece0ddaa700bb4bcfaf6a2b83f2eed148ea5374ef2b8f23e42d36de8823</originalsourceid><addsrcrecordid>eNp9ks9u1DAQxiMEolXpC3CyxIVLwP-SOByQVtsCRUWtRDlb42S86yqJg-0U7VPwyni7VSs44IM9sr_5eWb0FcVrRt8xSpv3kQlBaUk5KyljlJX8WXHMVN2WdVuz549xJY6K0xhvaV6ibVvGXhZHQnKmJKfHxe-1H2cIkNwdknNrsUuReEu-YbI-jG4iMPXkzM04J9fvBnJ9H0DEUpKLaeuMSz5EkoVfYYYJI5Irs9-vMxOnTPvl0pbc7GYkPIPAYML4gazIegA3RnIGCUzmke9p6XevihcWhoinD-dJ8ePT-c36S3l59flivbosO9m0qTQdcEDskPY9QEOpMdJ0FmwN3ChhOWLPpEKoRCPR5jvLBUrei7pHpbg4KT4euPNiRuy7XGmAQc_BjRB22oPTf79Mbqs3_k6rPLtGsAx4-wAI_ueCMenRxQ6HIc_AL1HzSqqay6qhWfrmH-mtX8KU29O8FYpVgnL1pNrAgNpN1ud_uz1Ur-qGtk0jK5lV_KDqgo8xoH0smVG9N4Y-GENnY-h7Y-h9s-KQFLN42mB4KuA_WX8AnKS7Ig</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2938153028</pqid></control><display><type>article</type><title>Comparative Effects of Metformin and Dipeptidyl Peptidase-4 Inhibitors in Japanese Obese Patients with Type 2 Diabetes: A Claims Database Study</title><source>Nexis UK</source><source>Springer Nature - SpringerLink Journals - Fully Open Access </source><source>Publicly Available Content (ProQuest)</source><source>PubMed Central</source><creator>Odawara, Masato ; Aoi, Sumiko ; Takeshima, Tomomi ; Iwasaki, Kosuke</creator><creatorcontrib>Odawara, Masato ; Aoi, Sumiko ; Takeshima, Tomomi ; Iwasaki, Kosuke</creatorcontrib><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 &lt; 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 (&gt; 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 &lt; 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 &amp; 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 &lt; 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 (&gt; 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 &lt; 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 &amp; 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 &amp; 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 &amp; Allied Health Source</collection><collection>Health &amp; 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 &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest Health &amp; Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health &amp; 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 &lt; 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 (&gt; 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 &lt; 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>
fulltext fulltext
identifier ISSN: 1869-6953
ispartof Diabetes therapy, 2021-08, Vol.12 (8), p.2165-2177
issn 1869-6953
1869-6961
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8342731
source Nexis UK; Springer Nature - SpringerLink Journals - Fully Open Access ; Publicly Available Content (ProQuest); PubMed Central
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
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-20T15%3A36%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comparative%20Effects%20of%20Metformin%20and%20Dipeptidyl%20Peptidase-4%20Inhibitors%20in%20Japanese%20Obese%20Patients%20with%20Type%202%20Diabetes:%20A%20Claims%20Database%20Study&rft.jtitle=Diabetes%20therapy&rft.au=Odawara,%20Masato&rft.date=2021-08-01&rft.volume=12&rft.issue=8&rft.spage=2165&rft.epage=2177&rft.pages=2165-2177&rft.issn=1869-6953&rft.eissn=1869-6961&rft_id=info:doi/10.1007/s13300-021-01101-2&rft_dat=%3Cgale_pubme%3EA670977454%3C/gale_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c479t-bca2aeece0ddaa700bb4bcfaf6a2b83f2eed148ea5374ef2b8f23e42d36de8823%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2938153028&rft_id=info:pmid/34218420&rft_galeid=A670977454&rfr_iscdi=true