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Efficacy of different dipeptidyl peptidase-4 (DPP-4) inhibitors on metabolic parameters in patients with type 2 diabetes undergoing dialysis

Authors
 Se Hee Park  ;  Joo Young Nam  ;  Eugene Han  ;  Yong-ho Lee  ;  Byung-Wan Lee  ;  Beom Seok Kim  ;  Bong-Soo Cha  ;  Chul Sik Kim  ;  Eun Seok Kang 
Citation
 Medicine, Vol.95(32) : 4543, 2016 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2016
MeSH
Adamantane/analogs & derivatives ; Adamantane/therapeutic use ; Blood Glucose/analysis ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy* ; Diabetes Mellitus, Type 2/metabolism ; Diabetic Nephropathies/therapy ; Dipeptidyl-Peptidase IV Inhibitors/therapeutic use* ; Female ; Glycated Hemoglobin A/analysis ; Humans ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/therapy ; Linagliptin/therapeutic use ; Lipids/blood ; Male ; Middle Aged ; Nitriles/therapeutic use ; Peritoneal Dialysis ; Pyrrolidines/therapeutic use ; Renal Dialysis ; Retrospective Studies ; Sitagliptin Phosphate/therapeutic use ; Treatment Outcome
Keywords
chronic kidney disease ; dialysis ; dipeptidyl peptidase-4 ; type 2 diabetes
Abstract
Hyperglycemia is associated with increased mortality and morbidity in patients with type 2 diabetes mellitus (T2DM) who are undergoing dialysis. Although dipeptidyl peptidase-4 (DPP-4) inhibitors have been widely used in end-stage renal disease (ESRD) patients with T2DM, there are few studies on their efficacy in this population. We studied the effect of 3 different DPP-4 inhibitors on metabolic parameters in ESRD patients with T2DM.Two hundred ESRD patients with T2DM who were treated with DPP-4 inhibitors (sitagliptin, vildagliptin, or linagliptin) were enrolled and analyzed retrospectively. The changes in glycated hemoglobin (HbA1c), fasting plasma glucose, and lipid profiles were assessed before and after 3 months of treatment with DPP-4 inhibitors. Subgroup analysis was done for each hemodialysis (HD) and peritoneal dialysis (PD) group.There was no significant difference in the decrease in the HbA1c level among sitagliptin, vildagliptin, and linagliptin treatment groups (-0.74?±?1.57, -0.39?±?1.45, and -0.08?±?1.40, respectively, P?=?0.076). The changes in fasting blood glucose and lipid profiles were also not significantly different. In HD patients (n?=?115), there was no difference in the HbA1c level among the 3 groups. In contrast, in PD patients (n?=?85), HbA1c was reduced more after 3 months of treatment with sitagliptin compared with vildagliptin and linagliptin (-1.58?±?0.95, -0.46?±?0.98, -0.04?±?1.22, respectively, P?=?0.001).There was no significant difference in the glucose-lowering effect between the different DPP-4 inhibitors tested in ESRD patients. In PD patients, sitagliptin tends to lower the HbA1c level more than the other inhibitors. The glucose-lowering efficacy of the 3 DPP-4 inhibitors was comparable.
DOI
10.1097/MD.0000000000004543
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Park, Se Hee(박세희)
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
Han, Eu Gene(한유진)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151815
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