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AIM: Pooled efficacy studies suggest that glycaemic responses to dipeptidyl-peptidase 4 inhibitors in type 2 diabetes are greatest in Asians, who may also respond better to alpha-glucosidase inhibitors. We assessed the glycaemic impact of sitagliptin by race in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), and whether this was enhanced in Asians with concomitant acarbose therapy. MATERIALS AND METHODS: TECOS enrolled 14 671 patients with type 2 diabetes, cardiovascular disease and HbA1c of 48-64 mmol/mol (6.5%-8.0%), and randomized them, double-blind, to sitagliptin or placebo. There were 3265 patients (22.3%) from Asian countries. Background glucose-lowering therapies were unaltered for the first 4 months post randomization unless clinically essential, facilitating comparison of sitagliptin-associated effects in self-identified East Asian, Other (South) Asian, White Caucasian, Hispanic, Black and Indigenous groups. RESULTS: Median baseline HbA1c by race was 54 to 57 mmol/mol (7.1%-7.4%). Mean 4-month reduction in placebo-adjusted HbA1c was greatest in East Asians (-6.6 mmol/mol [-0.60%] vs ≤6.0 mmol/mol [≤0.55%] in other groups), with significantly greater reduction vs the 2 largest groups (White Caucasians, Other Asians; P 

Original publication




Journal article


Diabetes Obes Metab

Publication Date





1427 - 1434


ethnicity, glycaemic control, sitagliptin, type 2 diabetes, Acarbose, Aged, Asia, Blacks, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Dipeptidyl-Peptidase IV Inhibitors, Double-Blind Method, Drug Administration Schedule, Drug Therapy, Combination, Female, Glycated Hemoglobin A, Glycoside Hydrolase Inhibitors, Hispanic or Latino, Humans, Hypoglycemic Agents, Male, Middle Aged, Sitagliptin Phosphate, Treatment Outcome, Whites