Li FF, et al. - This study was coordinated to examine whether vildagliptin add-on insulin therapy improved glycemic variations in patients with uncontrolled type 2 diabetes (T2D) compared to patients with placebo therapy. In patients with uncontrolled T2D, vildagliptin add-on therapy to insulin had the ability to improve glycemic variations, particularly during the nocturnal time period.

• The authors performanced a 24-week, single-center, double-blind, placebo-controlled trial.
• Between June 2012 and April 2013, they recruited inadequately controlled T2D patients treated with insulin therapy.
• The trial included a 2-week screening period and a 24-week randomized period.
• They randomly assigned subjects to a vildagliptin add-on insulin therapy group (n = 17) or a matched placebo group (n = 16).
• At weeks 4, 8, 12, 16, 20, and 24, scheduled visits occurred.
• They performed continuous glucose monitoring (CGM) before and at the endpoint of the study.

• In this study, 33 subjects were admitted, with 1 patient withdrawing from the placebo group.
• HbA1c values were significantly reduced at the endpoint in the vildagliptin add-on group after 24 weeks of therapy.
• CGM data demonstrated that patients with vildagliptin add-on therapy had a significantly lower 24-h mean glucose concentration and mean amplitude of glycemic excursion (MAGE).
• Compared to the control patients, patients in the vildagliptin add-on group had a significantly lower MAGE and standard deviation during the nocturnal period (0000-0600) at the endpoint of the study.
• In either group, a severe hypoglycemic episode was not observed.