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      Treatment Burden on Once-Weekly Omarigliptin Versus Daily Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes: Randomized Controlled Trial (ONWARD-DPP4 Study)


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          Preference for quality of life is important in deciding the treatment strategy for patients with type 2 diabetes mellitus. This study aimed to assess the effect of omarigliptin on patients’ psychological attitudes and responses compared with daily dipeptidyl peptidase-4 inhibitors (DPP4is) by measuring the burden of pharmacotherapy using the Diabetic Treatment Burden Questionnaire (DTBQ).


          Patients with type 2 diabetes mellitus who were taking daily DPP-4is were enrolled and randomized to a group that switched to omarigliptin or a group that continued daily DPP4is and were monitored for 12 weeks. The primary endpoint was the change in the DTBQ score from baseline to week 12. The secondary endpoints included changes in blood test results, medication preferences and medication adherence.


          The DTBQ total score significantly decreased from baseline to week 12 in both groups; however, no significant intergroup differences were observed. The DTBQ subscale, implementation and flexibility burden scores significantly decreased in the group that switched to omarigliptin, although no significant intergroup difference in the change was observed. DTBQ scores and medication preferences were associated with improvements in the DTBQ scores.


          Although this study failed to demonstrate the improvement of DTBQ total score by switching from daily DPP4is to omarigliptin compared with continuing the daily DPP4is, the DTBQ subscale score implementation and flexibility burden score were significantly improved only in the group that switched to omarigliptin, suggesting the possibility of switching from daily DPP4is to omarigliptin to decrease the patients’ medication burden.

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          Supplementary Information

          The online version contains supplementary material available at 10.1007/s13300-023-01442-0.

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          Most cited references20

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          Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

          The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self-management education and support. For those with obesity, efforts targeting weight loss, including lifestyle, medication, and surgical interventions, are recommended. With regards to medication management, for patients with clinical cardiovascular disease, a sodium–glucose cotransporter 2 (SGLT2) inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended. For patients with chronic kidney disease or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefit is recommended. GLP-1 receptor agonists are generally recommended as the first injectable medication.
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            Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34)

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              Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

              The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the previous consensus statements on the management of hyperglycemia in type 2 diabetes in adults, published since 2006 and last updated in 2019. The target audience is the full spectrum of the professional health care team providing diabetes care in the U.S. and Europe. A systematic examination of publications since 2018 informed new recommendations. These include additional focus on social determinants of health, the health care system, and physical activity behaviors, including sleep. There is a greater emphasis on weight management as part of the holistic approach to diabetes management. The results of cardiovascular and kidney outcomes trials involving sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists, including assessment of subgroups, inform broader recommendations for cardiorenal protection in people with diabetes at high risk of cardiorenal disease. After a summary listing of consensus recommendations, practical tips for implementation are provided.

                Author and article information

                Diabetes Ther
                Diabetes Ther
                Diabetes Therapy
                Springer Healthcare (Cheshire )
                19 July 2023
                19 July 2023
                October 2023
                : 14
                : 10
                : 1639-1658
                [1 ]GRID grid.410814.8, ISNI 0000 0004 0372 782X, Department of Doctor-Patient Relationships, , Nara Medical University, ; 840 Shijo-Cho, Kashihara, Nara 634-8521 Japan
                [2 ]GRID grid.414175.2, ISNI 0000 0004 1774 3177, Department of Endocrinology and Metabolism, , Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, ; Hiroshima, Hiroshima Japan
                [3 ]Futata Tetsuhiro Clinic, Fukuoka, Fukuoka Japan
                [4 ]Mikannohana Clinic Diabetes, Endocrinology and Metabolism, Matsuyama, Ehime Japan
                [5 ]TDE Healthcare Corporation TOSAKI Clinic for Diabetes and Endocrinology, Nagoya, Aichi Japan
                [6 ]Internal Medicine and Cardiovascular Murai Clinic, Bunkyo-ku, Tokyo, Japan
                [7 ]GRID grid.410807.a, ISNI 0000 0001 0037 4131, Department of Diabetes, Metabolism and Endocrinology, , The Cancer Institute Hospital of Japanese Foundation for Cancer Research, ; Koto-ku, Tokyo, Japan
                [8 ]STOP DM Suzuki Diabetes Clinic, Atsugi, Kanagawa Japan
                [9 ]Wakasa Medical Clinic, Kanazawa, Ishikawa Japan
                [10 ]Seino Internal Medical Clinic, Koriyama, Fukushima Japan
                [11 ]Oishi Clinic, Kyoto, Kyoto Japan
                [12 ]Oyama East Clinic, Oyama, Tochigi Japan
                [13 ]Higami Clinic of Rheumatology and Diabetology, Kashihara, Nara Japan
                [14 ]GRID grid.412755.0, ISNI 0000 0001 2166 7427, Division of Metabolism and Diabetes, Faculty of Medicine, , Tohoku Medical and Pharmaceutical University, ; Sendai, Miyagi Japan
                Author information
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                : 28 May 2023
                : 22 June 2023
                Funded by: FundRef http://dx.doi.org/10.13039/100016288, Kissei;
                Original Research
                Custom metadata
                © Springer Healthcare Ltd., part of Springer Nature 2023

                Endocrinology & Diabetes
                dipeptidyl peptidase-4 inhibitor,omarigliptin,quality of life,treatment burden,type 2 diabetes mellitus


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