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Ningrum VD, Ikawati Z, Sadewa AH, Ikhsan MR. Patient-factors associated with metformin steady-state levels in type 2 diabetes mellitus with therapeutic dosage. J Clin Transl Endocrinol 2018; 12:42-47. [PMID: 29892566 PMCID: PMC5992324 DOI: 10.1016/j.jcte.2018.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/07/2018] [Indexed: 01/08/2023] Open
Abstract
AIMS This prospective study aimed to analyze metformin steady-state concentration in repeated constant dosage and the influencing patient-factors as well as to correlate them with glycemic control. METHODS The validated HPLC-UV method was used to examine metformin steady-state concentration, while FBG and glycated albumin were used as the parameters of glycemic control during metformin administration. RESULTS A total of 82 type-2 diabetes patients were involved with 32.1% of them having metformin Cssmin and 84.1% having Cssmax of metformin within the recommended therapeutic range. One patient had metformin Css that exceeded minimum toxic concentration despite his normal renal function and administered therapeutic dosage of metformin. Higher Cssmax was found in patients with metformin monotherapy, while patients with longer duration of metformin use had significantly higher Cssmin. CONCLUSIONS Along with initial hyperglycemia and eGFR, metformin Cssmin became the only parameter that influenced FBG level (P < 0.05). Duration of previous metformin use should be considered in the strategy of optimizing metformin dosage. The type-2 diabetes patients with obesity are more suggested to take shorter interval of metformin administration (or possibly with sustained-release formulation) to keep Cssmin within the therapeutic range.
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Affiliation(s)
| | - Zullies Ikawati
- Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Ahmad H. Sadewa
- Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Mohammad R. Ikhsan
- Department of Internal Medicine, Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia
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Masumoto N, Otsuki H, Iwakawa S, Inada S, Goya K, Sho H, Suzuki S, Kurebayashi S, Hashimoto K, Koga M. Effects of alogliptin on the ratio of glycated albumin to HbA1c in patients with type 2 diabetes mellitus. Diabetol Int 2016; 8:212-217. [PMID: 30603324 DOI: 10.1007/s13340-016-0298-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/13/2016] [Indexed: 01/29/2023]
Abstract
The ratio of glycated albumin (GA) to HbA1c (the GA/HbA1c ratio) has been used as a glycemic control indicator that reflects postprandial plasma glucose levels or glycemic variability. In this study, we investigated the effects of alogliptin, a DPP-4 inhibitor, on the GA/HbA1c ratio in patients with type 2 diabetes mellitus. Thirty-eight patients with type 2 diabetes mellitus whose glycemic control was stable were enrolled, and alogliptin (12.5 or 25 mg/day) was then administered to them for 24 weeks. HbA1c and GA levels both significantly decreased after 24 weeks (P < 0.0001), whereas the GA/HbA1c ratio did not (P = 0.129). No correlation was observed between the change in the GA/HbA1c ratio (the ΔGA/HbA1c ratio) and HbA1c or GA level before the administration of alogliptin; however, a negative correlation was found between the ΔGA/HbA1c ratio and the GA/HbA1c ratio before the administration of alogliptin (R = -0.322, P = 0.049). Although the GA/HbA1c ratio in the low-value group (<2.80) was not significantly affected by the administration of alogliptin, that in the high-value group (≥2.80) significantly decreased (P = 0.008). The administration of alogliptin significantly decreased the GA/HbA1c ratio in the high-value group after 24 weeks. Alogliptin may be more useful for patients with high postprandial plasma glucose levels than in those with low postplandial plasma glucose levels.
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Affiliation(s)
- Norio Masumoto
- Department of Pharmacy, Kawanishi City Hospital, 5-21-1, Higashiuneno, Kawanishi, Hyogo 666-0195 Japan
| | - Hiroaki Otsuki
- Department of Pharmacy, Kawanishi City Hospital, 5-21-1, Higashiuneno, Kawanishi, Hyogo 666-0195 Japan
| | - Seigo Iwakawa
- 2Department of Pharmaceutics, Kobe Pharmaceutical University, Kobe, Japan
| | - Shinya Inada
- Department of Internal Medicine, Kawanishi City Hospital, Kawanishi, Hyogo Japan
| | - Kayoko Goya
- Department of Internal Medicine, Nishinomiya Municipal Hospital, Nishinomiya, Hyogo Japan
| | - Hiroyuki Sho
- 5Department of Internal Medicine, NTT West Osaka Hospital, Osaka, Japan
| | - Satoko Suzuki
- 5Department of Internal Medicine, NTT West Osaka Hospital, Osaka, Japan
| | - Shogo Kurebayashi
- Department of Internal Medicine, Nishinomiya Municipal Hospital, Nishinomiya, Hyogo Japan
| | | | - Masafumi Koga
- Department of Internal Medicine, Hakuhokai Central Hospital, Amagasaki, Hyogo Japan
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Mo Y, Ma X, Li H, Ran X, Yang W, Li Q, Peng Y, Li Y, Gao X, Luan X, Wang W, Xie Y, Zhou J, Jia W. Relationship between glycated albumin and glycated hemoglobin according to glucose tolerance status: A multicenter study. Diabetes Res Clin Pract 2016; 115:17-23. [PMID: 27242118 DOI: 10.1016/j.diabres.2016.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 11/13/2015] [Accepted: 03/01/2016] [Indexed: 02/05/2023]
Abstract
AIMS To determine the relationship between glycated albumin (GA) and glycated hemoglobin (HbA1c) and to explore the association of glycated albumin/glycated hemoglobin (GA/HbA1c) ratio with glucose indices in Chinese subjects with varying glucose tolerance status. METHODS This hospital-based, cross-sectional study involved 953 participants without known diabetes from 11 centers in China. Oral glucose tolerance test (OGTT) was used to identify three groups of subjects: normal glucose regulation (n=194), impaired glucose regulation (n=303) and newly diagnosed type 2 diabetes group (n=456). The GA, HbA1c and GA/HbA1c ratio were tested. RESULTS GA was positively correlated with HbA1c (r=0.832, P<0.001). After correcting for age, sex and BMI, the correlations remained significant (r=0.824, P<0.001). Linear regression analysis estimated that a 1% increase of HbA1c was associated with a 2.84% increase of GA (GA=2.843×HbA1c-0.203; R(2)=0.692, P<0.001). GA would be 18.3 (16.7-19.9)% and 19.7 (18.0-21.4)% with HbA1c of 6.5% (48mmol/mol) and 7.0% (53mmol/mol). The mean GA/HbA1c ratio was 2.81±0.38, and it significantly increased with the presence of glucose intolerance (all, P<0.05). In the total study population, GA/HbA1c was correlated with BMI, glucose levels and 30-min insulin during OGTT, the homeostatic model assessment of β-cell function (HOMA-β), and ΔI30/ΔG30 (all, P<0.05). Increased glucose at 30min (standardized β=0.221, P<0.001), and decreased BMI (standardized β=-0.114, P=0.008) were associated with elevated GA/HbA1c ratio by multiple linear regression (adjusted R(2)=0.045). CONCLUSIONS The relationship between GA and HbA1c was strong. The GA/HbA1c ratio was related to acute postprandial glucose fluctuation and BMI level.
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Affiliation(s)
- Yifei Mo
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Hong Li
- Department of Endocrinology and Metabolism, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xingwu Ran
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Wenying Yang
- Department of Endocrinology and Metabolism, China-Japan Friendship Hospital, Beijing, China
| | - Qiang Li
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yongde Peng
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai, China
| | - Yanbing Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xin Gao
- Department of Endocrinology and Metabolism, Fudan University Affiliated Zhongshan Hospital, Shanghai, China
| | - Xiaojun Luan
- Department of Endocrinology and Metabolism, The First People's Hospital of Foshan, Foshan, China
| | - Weiqing Wang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Xie
- Department of Diabetic Neurology, Metabolic Disease Hospital, Tianjin Medical University, Tianjin, China
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China; Department of Endocrinology and Metabolism, Kashgar Prefecture Second People's Hospital, Kashgar, Xinjiang, China.
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
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