15 October 2025
: Case report 
Gastric Emptying Delay with Pre-Meal Administration of Metformin and Anagliptin in Type 2 Diabetes: Effects on Postprandial Glucose and Triglyceride Levels in a Two-Case Report
Unusual or unexpected effect of treatment
Koichiro Murata
ABCDEFG 1*, Daisuke Sato ABCDEFG 1, Katsutaro Morino ABCDEFG 1,2, Shogo Ida ABCDEFG 1, Natsuko Ohashi ABCDEFG 1, Daisuke Takenaka BCDEF 1, Natsuko Kitagawa BCDEF 1, Mayu Shigemi BCDEF 1, Itsuko Miyazawa ABCDEFG 1, Tsuyoshi Yanagimachi ABCDEFG 1,3, Yukihiro Fujita ABCDEFG 1,3, Hiroshi Maegawa ABCDEFG 1,4, Shinji Kume ABCDEFG 1
DOI: 10.12659/AJCR.948812
Am J Case Rep 2025; 26:e948812
Figure 1 Study design and protocol. (A) Study design. (B) Protocol for the meal and 13C-acetate tests for patients treated with a metformin/anagliptin combination tablet preprandially (pre-Met/Ana) or postprandially (post-Met/Ana). The patients ingested cookies containing 75 g carbohydrate (flour starch and maltose) and 28.5 g fat. The patients drank liquid containing the sodium 13C-acetate 5 min after starting to eat the cookies. Blood samples were collected while fasting (−30, 0 min) and 30, 60, 120, 180, and 240 min after the ingestion of the cookies. Exhaled breath samples were collected 0, 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, and 240 min after the ingestion of the cookies. TG – triglyceride; Met – metformin; Ana – anagliptin.