Short-term renal and metabolic effects of low dose vildagliptin treatment added-on insulin therapy in non-proteinuric patients with type 2 diabetes: open-label randomized prospective study
| Autor: | Valentina Bayrasheva, Vladimir Dobronravov, Volha Vasilkova, Ivan Pchelin, Svetlana Chefu, Alina Babenko, Natalia Hudiakova, Pavel A. Andoskin, Ivan S. Shatalov, Alexandra N. Ivanova, Elena N. Grineva |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Urology Renal function 030209 endocrinology & metabolism Type 2 diabetes Kidney Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Diabetes mellitus cystatin C medicine Humans Hypoglycemic Agents Insulin Vildagliptin Prospective Studies NGAL Aged Creatinine biology business.industry renal function type IV collagen Middle Aged medicine.disease RC648-665 Cystatin C chemistry Diabetes Mellitus Type 2 030220 oncology & carcinogenesis biology.protein Medicine Female type 2 diabetes business medicine.drug Kidney disease |
| Zdroj: | Archives of Endocrinology and Metabolism, Issue: ahead, Published: 06 APR 2020 Archives of Endocrinology and Metabolism, Vol 64, Iss 4, Pp 418-426 (2020) Archives of Endocrinology and Metabolism, Volume: 64, Issue: 4, Pages: 418-426, Published: 06 APR 2020 Archives of Endocrinology and Metabolism v.64 n.4 2020 Arquivos de Endocrinologia e Metabolismo Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) instacron:SBEM |
| Popis: | Objective The aim of this randomized comparative study was to assess renal and metabolic effects of vildagliptin in insulin-treated type 2 diabetes (T2DM) patients without overt chronic kidney disease. Subjects and methods We randomized 47 insulin-treated non-proteinuric patients with satisfactory controlled T2DM and estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m 2 either to continue insulin therapy (control) or to receive combined insulin-vildagliptin treatment (VIG group). We assessed eGFR using serum creatinine (eGFRcreat), cystatin C (eGFRcys), and both (eGFRcreat-cys), and urinary creatinine-adjusted excretion of albumin (UACR), type IV collagen (uCol IV/Cr), and neutrophil gelatinase-associated lipocalin (uNGAL/Cr) at baseline and after 6 months of treatment. Results Study groups were comparable in terms of age and sex (60.1 ± 6.1 years and 42.9% men in control group vs. 60.8 ± 5.2 years and 39.1% in VIG group). After 6 months of treatment, there were no significant changes in main assessed parameters in control group. VIG group demonstrated significant decrease in HbA1c, diastolic blood pressure, frequency of hypoglycemia, and high-sensitivity C-reactive protein level as compared to the changes in control group. While eGFRcreat, UACR, and uNGAL/Cr showed no significant changes after vildagliptin addition, eGFRcys, eGFRcreat-cys, and uCol IV/Cr changed significantly in comparison with control group (+7.0% [3.7;13.3]; +5.1% [1.4;8.5]; -32,8% [-55.8;-24.4], respectively, p < 0.01 each). Correlation and regression analysis revealed glucose-independent pattern of these changes. Conclusion Addition of vildagliptin to ongoing insulin therapy in patients with T2DM was associated with a reduction in uCol IV/Cr and an increase in eGFRcys and eGFRcreat-cys, independent of T2DM control parameters. |
| Databáze: | OpenAIRE |
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