The aim of this study was to evaluate the effect of gemigliptin vs sitagliptin or glimepiride as initial combination therapy with metformin on glycaemic variability and to assess the correlation between glycaemic variability reduction and the dipeptidyl peptidase-4 (DPP-4) inhibition in patients with type 2 diabetes. This multicentre, randomized, active-controlled, open-label exploratory study included 69 patients with HbA1c > 7.5%. Subjects were randomized to receive gemigliptin 50 mg (n = 24), sitagliptin 100 mg (n = 23) or glimepiride 2 mg (n = 22) for 12 weeks. After 12 weeks, the change in mean amplitude of glycaemic excursion (MAGE) compared with baseline was significantly lower in the DPP-4 inhibitor groups compared with that in patients who received glimepiride. Furthermore, the standard deviation (SD) of glucose was significantly lower in patients who received gemigliptin than that in patients who received sitagliptin or glimepiride. The DPP-4 inhibition was significantly correlated with changes in MAGE and SD of glucose. In conclusion, gemigliptin and sitagliptin were more effective than glimepiride in reducing glycaemic variability as initial combination therapy with metformin in patients with type 2 diabetes, and the DPP-4 inhibition was associated with a reduction in glycaemic variability.

A 12-week treatment with gemigliptin improved glycaemic control and provided UACR reduction in T2DM patients with moderate to severe RI. Gemigliptin was well tolerated, with no additional risk of hypoglycaemia and change in body weight.

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A B S T R A C TBackgrounds: After shoulder dislocation, kinematic changes in shoulder, including translation of the humeral head, ensue. There have been many attempts to measure these changes using motion measurement techniques, but in vivo three-dimensional (3D) glenohumeral changes have not been appreciated until now. The purpose of this study was to measure and analyze changes in glenohumeral translation in patients with shoulder dislocation and compare these changes with healthy shoulder. Methods: We included 20 subjects who had suffered shoulder dislocation for first time, and 3D models of their humerus and scapula were obtained using computed tomography and fluoroscopic images during scapular plane abduction and external rotation of shoulder with elbow flexed at 90and arm abducted at 90. We measured the superior/inferior (SI) and anterior/posterior (AP) translations for both shoulders. Results: No statistically significant difference between healthy and dislocated shoulders was detected in SI translation for scapular plane abduction with increasing elevation angles. In AP translation, the humeral head was located 2.29 mm more anteriorly in the dislocated shoulder than in the healthy shoulder. However, no statistically significant difference was seen. For internal to external rotation, the angle of the rotated arm had an effect on AP translation. However, no statistically significant difference was detected. In the apprehension test, there was no significant difference in the mean value of AP translation. Conclusion: Compared with the contralateral healthy shoulder, changes in glenohumeral translation during in vivo movement after shoulder dislocation were found to be non-significant.