Effects of sitagliptin on counter‐regulatory and incretin hormones during acute hypoglycaemia in patients with type 1 diabetes: a randomized double‐blind placebo‐controlled crossover study
| Autor: | Brian M. Frier, R. Zwertbroek, J. J. Holst, Joost B. L. Hoekstra, A. M. E. Stades, Mariëtte T. Ackermans, Filip K. Knop, Frits Holleman, J. J. J. de Sonnaville, Josefine E. Schopman, B. Hartmann |
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| Přispěvatelé: | Other departments, ACS - Amsterdam Cardiovascular Sciences, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, General Internal Medicine, Other Research, Laboratory for Endocrinology |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Incretin Gastric Inhibitory Polypeptide Placebo Incretins Glucagon Young Adult Endocrinology Double-Blind Method Glucagon-Like Peptide 1 Internal medicine Internal Medicine medicine Humans Dipeptidyl peptidase-4 Dipeptidyl-Peptidase IV Inhibitors Type 1 diabetes Cross-Over Studies business.industry Sitagliptin Phosphate Middle Aged medicine.disease Crossover study Glucagon-like peptide-1 Hypoglycemia Diabetes Mellitus Type 1 Growth Hormone Sitagliptin business hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Diabetes, obesity & metabolism, 17(6), 546-553. Wiley-Blackwell |
| ISSN: | 1463-1326 1462-8902 |
| DOI: | 10.1111/dom.12453 |
| Popis: | Aims To assess whether the dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin affects glucagon and other counter-regulatory hormone responses to hypoglycaemia in patients with type 1 diabetes. Methods We conducted a single-centre, randomized, double-blind, placebo-controlled, three-period crossover study. We studied 16 male patients with type 1 diabetes aged 18–52 years, with a diabetes duration of 5–20 years and intact hypoglycaemia awareness. Participants received sitagliptin (100 mg/day) or placebo for 6 weeks and attended the hospital for three acute hypoglycaemia studies (at baseline, after sitagliptin treatment and after placebo). The primary outcome was differences between the three hypoglycaemia study days with respect to plasma glucagon responses from the initialization phase of the hypoglycaemia intervention to 40 min after onset of the autonomic reaction. Results Sitagliptin treatment significantly increased active levels of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1. No significant differences were observed for glucagon or adrenergic counter-regulatory responses during the three hypoglycaemia studies. Growth hormone concentration at 40 min after occurrence of autonomic reaction was significantly lower after sitagliptin treatment [median (IQR) 23 (0.2–211.0) mEq/l] compared with placebo [median (IQR) 90 (8.8–180) mEq/l; p = 0.008]. Conclusions Sitagliptin does not affect glucagon or adrenergic counter-regulatory responses in patients with type 1 diabetes, but attenuates the growth hormone response during late hypoglycaemia. |
| Databáze: | OpenAIRE |
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