The Effect of DPP4 Inhibitor on Glycemic Variability in Patients with Type 2 Diabetes treated with twice-daily Premixed Human Insulin.

Autor:	Tan FHS; Endocrine Unit, Department of Medicine, Sarawak General Hospital, Malaysia., Tong CV; Department of Medicine, Hospital Melaka, Malaysia., Tiong XT; Clinical Research Center, Sarawak General Hospital, Malaysia., Lau BK; Endocrine Unit, Department of Medicine, Sarawak General Hospital, Malaysia., Kuan YC; Endocrine Unit, Department of Medicine, Sarawak General Hospital, Malaysia., Loh HH; Faculty of Medicine and Health Sciences, University of Malaysia Sarawak (UNIMAS), Malaysia., Pillai SAV; Department of Medicine, Hospital Melaka, Malaysia.
Jazyk:	angličtina
Zdroj:	Journal of the ASEAN Federation of Endocrine Societies [J ASEAN Fed Endocr Soc] 2021; Vol. 36 (2), pp. 167-171. Date of Electronic Publication: 2021 Sep 03.
DOI:	10.15605/jafes.036.02.11
Abstrakt:	Objective: To evaluate the effect of adding DPP4 inhibitor (DPP4-i) on glycemic variability (GV) in patients with type 2 diabetes mellitus (T2DM) treated with premixed human insulin (MHI). Methodology: We conducted a prospective study in patients with T2DM on twice-daily MHI with or without metformin therapy. Blinded continuous glucose monitoring was performed at baseline and following 6 weeks of Vildagliptin therapy. Results: Twelve patients with mean (SD) age of 55.8 (13.1) years and duration of disease of 14.0 (6.6) years were recruited. The addition of Vildagliptin significantly reduced GV indices (mmol/L): SD from 2.73 (IQR 2.12-3.66) to 2.11 (1.76-2.55), p =0.015; mean amplitude of glycemic excursions (MAGE) 6.94(2.61) to 5.72 (1.87), p =0.018 and CV 34.05 (8.76) to 28.19 (5.36), p =0.010. In addition, % time in range (3.9-10 mmol/l) improved from 61.17 (20.50) to 79.67 (15.33)%, p =0.001; % time above range reduced from 32.92 (23.99) to 18.50 (15.62)%, p =0.016; with reduction in AUC for hyperglycemia from 1.24 (1.31) to 0.47 (0.71) mmol/day, p =0.015. Hypoglycemic events were infrequent and the reduction in time below range and AUC for hypoglycemia did not reach statistical significance. Conclusion: The addition of DPP4-I to commonly prescribed twice-daily MHI in patients with T2DM improves GV and warrants further exploration. Competing Interests: The authors declared no conflicts of interest. (© 2021 Journal of the ASEAN Federation of Endocrine Societies.)
Databáze:	MEDLINE
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