Mechanistic insights from sequential combination therapy with a sodium glucose co-transporter-2 inhibitor and a dipeptidyl peptidase-4 inhibitor: Results from the CANARIS Trial using canagliflozin and teneligliptin.

摘要: Aim To elucidate the mechanisms involved in sequential use of SGLT2 and DPP4 inhibitors (SGLT2i DPP-4i). Methods Twenty-six type-2 diabetes mellitus patients were recruited into a stepped regimen 100 mg canagliflozin daily from day 1, supplemented with 20 teneligliptin 4. Glucose (Glu), insulin glucagon measured at fasting after ingesting mixed meal on days 4 6. Results Canagliflozin decreased plasma glucose to an extent inversely proportional change glucagon-to-insulin (G/I) ratio. This correlation was maintained when adding teneligliptin, while area under curve Glu (GluAUC) correlated closely that G/I ratio 60 min canagliflozin. Moreover, these correlations persisted 120 postprandially, but not 6 added. Conclusion The result suggested dominant mechanism responsible for metabolism reflected attributable SGLT2i its active persisted, despite DPP-4i.