{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T04:33:58Z","timestamp":1776486838215,"version":"3.51.2"},"reference-count":31,"publisher":"American Diabetes Association","issue":"11","license":[{"start":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T00:00:00Z","timestamp":1476921600000},"content-version":"vor","delay-in-days":52,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K08-DK-0830361"],"award-info":[{"award-number":["K08-DK-0830361"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000098","name":"National Institutes of Health Clinical Center","doi-asserted-by":"publisher","award":["M01-RR-00039"],"award-info":[{"award-number":["M01-RR-00039"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017802","name":"Jacobs Family Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017802","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>After intensive insulin treatment, many obese African American patients with new-onset diabetic ketoacidosis (DKA) and severe hyperglycemia are able to achieve near-normoglycemia remission. The optimal treatment to prevent hyperglycemic relapses after remission is not known.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>This prospective, 4-year, placebo-controlled study randomly assigned 48 African American subjects with DKA and severe hyperglycemia to metformin 1,000 mg daily (n = 17), sitagliptin 100 mg daily (n = 16), or placebo (n = 15) after normoglycemia remission. Hyperglycemic relapse was defined as fasting glucose &amp;gt;130 mg\/dL (7.2 mmol\/L) and HbA1c &amp;gt;7.0% (53 mmol\/mol). Oral glucose tolerance tests were conducted at randomization and at 3 months and then every 6 months for a median of 331 days. Oral minimal model and incremental area under the curve for insulin (AUCi) were used to calculate insulin sensitivity (Si) and \u03b2-cell function, respectively. Disposition index (DI) was calculated as a product of Si and incremental AUCi.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Relapse-free survival was higher in sitagliptin and metformin (P = 0.015) compared with placebo, and mean time to relapse was significantly prolonged in the metformin and sitagliptin groups compared with the placebo group (480 vs. 305 days, P = 0.004). The probability of relapse was significantly lower for metformin (hazard ratio 0.28 [95% CI 0.10\u20130.81]) and sitagliptin (0.31 [0.10\u20130.98]) than for placebo. Subjects who remained in remission had a higher DI (P = 0.02) and incremental AUCi (P &amp;lt; 0.001) than those with hyperglycemia relapse without significant changes in Si.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This study shows that near-normoglycemia remission was similarly prolonged by treatment with sitagliptin and metformin. The prolongation of remission was due to improvement in \u03b2-cell function.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc16-0406","type":"journal-article","created":{"date-parts":[[2016,8,30]],"date-time":"2016-08-30T02:03:21Z","timestamp":1472522601000},"page":"1948-1955","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":28,"title":["Randomized Controlled Study of Metformin and Sitagliptin on Long-term Normoglycemia Remission in African American Patients With Hyperglycemic Crises"],"prefix":"10.2337","volume":"39","clinical-trial-number":[{"clinical-trial-number":"nct01099618","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Priyathama","family":"Vellanki","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn D.","family":"Smiley","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darko","family":"Stefanovski","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Anzola","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenlan","family":"Duan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Hudson","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Limin","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco J.","family":"Pasquel","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillermo E.","family":"Umpierrez","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2016,8,29]]},"reference":[{"key":"2022031301071804700_B1","doi-asserted-by":"crossref","first-page":"790","DOI":"10.2337\/diab.44.7.790","article-title":"Diabetic ketoacidosis in obese African-Americans","volume":"44","author":"Umpierrez","year":"1995","journal-title":"Diabetes"},{"key":"2022031301071804700_B2","doi-asserted-by":"crossref","first-page":"337","DOI":"10.2337\/diab.45.3.337","article-title":"Long-term normoglycemic remission in black newly diagnosed NIDDM subjects","volume":"45","author":"Banerji","year":"1996","journal-title":"Diabetes"},{"key":"2022031301071804700_B3","doi-asserted-by":"crossref","first-page":"350","DOI":"10.7326\/0003-4819-144-5-200603070-00011","article-title":"Narrative review: ketosis-prone type 2 diabetes mellitus","volume":"144","author":"Umpierrez","year":"2006","journal-title":"Ann Intern Med"},{"key":"2022031301071804700_B4","doi-asserted-by":"crossref","first-page":"741","DOI":"10.2337\/diab.43.6.741","article-title":"GAD antibody negative NIDDM in adult black subjects with diabetic ketoacidosis and increased frequency of human leukocyte antigen DR3 and DR4. 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