DIANA study investigators. Effects of voglibose and nateglinide on glycemic status and coronary atherosclerosis in early-stage diabetic patients

• Kataoka Yu

  Department of Internal Medicine, National Cerebral and Cardiovascular Center

• Yasuda Satoshi

  Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine

• Miyamoto Yoshihiro

  Department of Preventive Cardiology, National Cerebral and Cardiovascular Center

• Sase Kazuhiro

  Department of Clinical Pharmacology, Juntendo University School of Medicine

• Kosuge Masami

  Division of Cardiology, Yokohama City University Medical Center

• Kimura Kazuo

  Division of Cardiology, Yokohama City University Medical Center

• Yoshimasa Yasunao

  Department of Atherosclerosis and Diabetes, National Cerebral and Cardiovascular Center

• Miyazaki Shunichi

  Division of Cardiology, Department of Internal Medicine, Kinki University School of Medicine

• on behalf of the DIANA study investigators

• Kataoka Y

• Kawamura A

• Morii I

• Otsuka Y

• Miyamoto Y

• Yoshimasa Y

• Kada A

• Yonemoto N

• Maeda H

• Yamada K

• Kosuge M

• Kimura K

• Takewa M

• Miyazaki S

• Takamizawa I

• Tobaru T

• Hotta D

• Furukawa H

• Kimura T

• Ohashi J

• Itoh A

• Saito K

• Kokubu N

• Nagao K

• Anzai S

• Yokoi H

• Yamamoto Y

書誌事項

タイトル別名

• Effects of Voglibose and Nateglinide on Glycemic Status and Coronary Atherosclerosis in Early-Stage Diabetic Patients

抄録

Background: Postprandial hyperglycemia and hyperinsulinemia have been considered as important determinants for the development of atherosclerosis. However, it remains to be elucidated whether correction of the postprandial glycemic status prevents atherosclerotic changes. Methods and Results: The DIANA (DIAbetes and diffuse coronary NArrowing) study is a prospective randomized open-label multicenter trial. The 302 patients with coronary artery disease (CAD), impaired glucose tolerance/diabetes mellitus (DM) pattern according to 75-g oral glucose tolerance test and HbA_1c <6.9% were randomly assigned to life-style intervention (n=101), voglibose (0.9mg/day, n=100) or nateglinide treatment (180mg/day, n=101). We compared 1-year coronary atherosclerotic changes evaluated by quantitative coronary arteriography. Although voglibose significantly increased the number of patients with normal glucose tolerance at 1 year, there were no significant differences in coronary atherosclerotic changes at 1 year. However, overall, less atheroma progression was observed in patients in whom glycemic status was improved at 1 year (%change in total lesion length: 3.5% vs. 26.2%, P<0.01, %change in averaged lesion length: 0.7% vs. 18.6%, P=0.02). Conclusions: Although coronary atherosclerotic changes were similar for voglibose and nateglinide, an improvement in glycemic status at 1 year was associated with less atheroma progression regardless of the treatment. Our findings underscore the management of glycemic abnormality to prevent coronary atherosclerotic changes in Japanese early-stage DM patients with CAD. (Circ J 2012; 76: 712-720)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 76 (3), 712-720, 2012

  一般社団法人 日本循環器学会

キーワード

• Coronary artery atherosclerosis
• Diabetes mellitus
• Impaired glucose tolerance
• Postprandial hyperglycemia

詳細情報

• CRID: 1390282680081862144
• NII論文ID: 10030130334
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-11-1011
• COI: 1:CAS:528:DC%2BC38XltFKrsLs%3D
• ISSN: 13474820
• ISSN: 13469843
• PubMed: 22240597
• Web Site: http://www.jstage.jst.go.jp/article/circj/76/3/76_CJ-11-1011/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2012244841
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
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