Background: Glycemic variability is a risk factor for total death and cardiovascular events. There are
no obvious guidelines for the direct treatment of glycemic variability, but it can be improved with the treatment of
Objective: We compared the effect of repaglinide versus the combination of mitiglinide and voglibose, used to
improve postprandial hyperglycemia, on glycemic variability in Japanese patients with type 2 diabetes.
Methods: We performed an open-label randomized cross-over trial between April 2016 and April 2018. Patients
with type 2 diabetes who were admitted to our hospital were enrolled in our study (n = 12). Glycemic variability.
was assessed using a continuous glucose monitoring system.
Results: The average glucose level of the repaglinide phase (146.1 ± 20.7 mg/dl) and the combination of
mitiglinide and voglibose phase (132.3 ± 19.8 mg/dl) were similar (P = 0.10). The standard division (P = 0.0005),
coefficient of variation (P = 0.006), and mean amplitude of glycemic excursion (P = 0.002) of glucose were lower
in the combination of mitiglinide and voglibose phase than in the repaglinide phase.
Conclusion: Treatment with the combination of mitiglinide and voglibose might be more effective than repaglinide
for the improvement of glycemic variability.