Abstrakt

Short-term efficacy of incretin-related drugs among Asian patients monitored by glucose area under the curve calculated without blood sampling

Keisuke Kosugi*, Kenya Sakamoto, Kazutomi Yoshiuchi, Toshiyuki Sato, Seiki Okada, Yasuhito Ohnishi, Hiroyuki Koga, Kazutoshi Tokunaga, Chihiro Suminaka & Hiromu Nakajima

Objectives: To maximize the benefit of diabetes treatment, appropriate monitoring of the effect and modification of therapy plan is crucial. Among existing indices, only few are known to be suitable for the evaluation of short-term drug efficacy, such as on a weekly basis. In this paper, a novel, minimally invasive system of measuring glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET) was evaluated for realization of the effective 1-week treatment using incretin-related drugs.

Materials and Methods: Twenty inpatients with type 2 diabetes were administered a 75 g oral glucose tolerance test (OGTT). Incretin-related drugs (one of the followings; Exenatide, Liraglutide, Alogliptin, or Lixisenatide) were administered for the following 4-7 days, followed by another OGTT to evaluate response. Plasma glucose (PG) levels were measured every 30 min for 2 h to calculate reference AUC. Interstitial fluid glucose AUC was simultaneously measured using MIET.

Results: A significant correlation among AUCs predicted by MIET (IG-AUC) and the reference AUCs calculated using PG levels (PG-AUC) were observed both before and after medication (r=0.89). Both IG-AUC and PG-AUC were significantly reduced by medication, and peak glucose levels were significantly correlated with IG-AUC regardless of peak time (r=0.87).

Conclusions: There was a clear benefit of one week treatment of incretins for glycemic control. The efficacy of medication reflected by glucose AUC can be evaluated by MIET. Therefore, MIET could contribute to the optimization of therapy by monitoring short-term changes in glucose tolerance without blood sampling.