Combination therapy of alpha-glucosidase inhibitor and a sulfonylurea compound prolongs the duration of good glycemic control

The aim of this study was to investigate whether combination therapy of alpha-glucosidase inhibitor and a sulfonylurea (SU) drug can prolong the duration of good glycemic control compared with SU alone in patients with type 2 diabetes. The open prospective study included 124 Japanese patients with type 2 diabetes and inadequate glycemic control (hemoglobin A 1c [HbA 1c] gt; 7.0%). Patients were given either voglibose plus a SU compound (glibenclamide or gliclazide, n = 61) or SU drug alone (n = 63). The first 6-month run-in period (targeted to HbA 1c [le ] 7.0%) was followed by treatment for 3 years. The endpoint was deterioration of glycemic control (HbA 1c [ge ] 8.0%). Fifty patients on combination therapy and 48 patients on SU alone completed the trial. During the follow-up, 21 patients on combination therapy and 30 patients on SU alone showed deterioration of glycemic control and reached the endpoint ( P = .04). The combination therapy significantly prolonged the duration of good glycemic control (HbA 1c [lt ] 8.0%) compared with SU alone by Kaplan-Meier estimated survival analysis using a log-rank test ( P = .02). Thus, combination therapy with voglibose and a SU agent prolongs the duration of good glycemic control compared with SU alone in patients with type 2 diabetes.