ABSTRACT
Aim: This study aims to evaluate the effectiveness and safety of teneligliptin when switched from other gliptins in patients notcontrolled on oral antidiabetic drugs in Type 2 diabetes mellitus (T2DM).Methodology: Data of T2DM patients who were switched from other gliptins to teneligliptin uncontrolled by dual or triple drugtherapy. Data of at least 3 months were collected from hospital records and analyzed. Efficacy was evaluated by the changesin fasting blood sugar (FBS), postprandial blood sugar (PPBS), and hemoglobin A1c (HbA1c) from the baseline.Results: A total of 97 patients’ data were collected and were analyzed. The mean age of the patients was 59.9 years andmean duration of diabetes was 16 years. Hypertension (61.9%) was the common comorbid condition with diabetes. Sitagliptinwas most prescribed dipeptidyl peptidase-4 (DPP-4) inhibitors with 65 (67%) patients with a mean dose of 88.5 mg, followedby vildagliptin with 10 (10.3%) patients was prescribed with a mean dose of 95 mg. Metformin and glimepiride were the mostcommon combination used with these DPP-4 inhibitors 91 (93.8%) patients and 69 patients (71.1%) were prescribed, respectively.There was a significant reduction in FBS, PPBS, and HbA1c from the baseline with a difference of 45 mg/dL, 102 mg/dL, and1.6%, respectively, after switching to teneligliptin from other gliptins. Teneligliptin was well tolerated and no serious adverseevents were reported.Conclusion: Teneligliptin was effective in significantly reducing FBS, PPBS, and HbA1c when switching from other gliptins inT2DM patients not controlled with other antidiabetic agents. The drug was well tolerated and no serious adverse events werereported.
ABSTRACT
Background: Type2 diabetes mellitus (T2DM) is a highly inheritable disease. Transcription factor 7- like 2 (TCF7L2) gene regulates the expression of glucagon-like peptide 1 (GLP-1) in L cells of small intestine. GLP1 plays a critical role in blood glucose homeostasis by stimulating postprandial insulin secretion and increasing insulin sensitivity. Aim of the study: TCF7L2 gene variants may affect the susceptibility to Type 2 diabetes by altering GLP-1 levels. Materials and methods: This case-control study was conducted with 90 newly diagnosed patients with Type2 diabetes mellitus as cases and 90 age and sex-matched healthy volunteers as controls. TCF7L2 rs7903146 genotyping was done and we also estimated Fasting and postprandial GLP -1 level, Fasting and Postprandial insulin level and calculated HOMA-IR in both cases and controls. Results: Out study showed that T+ genotype, lower fasting GLP-1 level and lower postprandial GLP1 levels were more observed among cases as compared to controls. Low mean GLP 1 activity, high Mean HOMA-IR, low postprandial insulin, low percentage rise in insulin were observed among T+ genotype than among T- genotypic individuals. Conclusion: Hence, the study concludes that T+ genotype causes a decrease in GLP-1 levels, which in turn by decreasing postprandial insulin levels and by increasing insulin resistance increases the risk of Type2 diabetes.
ABSTRACT
Background: The prevalence of chronic kidney disease is increasing with diabetic nephropathy as the common underlying cause. Although numerous drugs are being used to improve glycaemic control, evidence in patients with diabetic nephropathy is sparse. The aim of the present was to evaluate the effectiveness of sitagliptin or vildagliptin addition on glycaemic control in patients with T2DM undergoing haemodialysis as part of their routine care in a rural tertiary care setting.Methods: Type 2 diabetic patients on maintenance haemodialysis as part of routine care and whose glycaemia was not controlled adequately and prescribed one of the oral gliptins once daily in addition to existing therapy for a period of 24 weeks were included in the present study. Effectiveness was assessed in terms of glycaemic control as measured by the change over time in glycated haemoglobin. Data analysis included glycated haemoglobin, body weight, serum creatinine, urine albumin creatinine ratio and the occurrence of hypoglycaemia.Results: Significant reduction in glycated haemoglobin values were noted after 24 weeks of therapy with gliptins similar to insulin glargine with a small weight loss. There was an insignificant decrease in the serum creatinine and urine albumin excretion levels after treatment with vildagliptin with Vildagliptin producing a slightly higher decrease but there was no correlation with changes in A1c levels. The overall incidence of adverse experiences was low and generally mild in both groups.Conclusions: In a group of Asian Indian patients with diabetic nephropathy due to T2DM undergoing haemodialysis in whom glycaemia was not controlled adequately, addition of gliptins helped to achieve glycaemic control to a similar extent as insulin glargine but with a marginal weight advantage.
ABSTRACT
Type 2 diabetes mellitus is a chronic metabolic disorder that results from defects in both insulin secretion and insulin action. Tight glycemic control is considered to be important in the therapy of type 2 diabetes mellitus, but treatment with a single agent is not sufficient to achieve this for the majority of patients. So, there is a need for new antidiabetic agents with favorable side effect profiles to use in combination therapy. The gliptins, an emerging new class of oral drugs for type 2 diabetes mellitus, lower blood glucose levels by a novel mechanism of inhibiting the enzyme dipeptidyl peptidase-4 (DPP-4) that inactivates incretin, released from the intestine following a meal to increase pancreatic insulin secretion. Gliptins enhance the circulating levels of incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) and improve glycemic control. This therapeutic approach carries a low-risk of interprandial hypoglycemia, does not cause weight gain and is well-tolerated. The first gliptin, sitagliptin (Januvia), was introduced in the UK in April 2007 as add-on therapy for patients with type 2 diabetes inadequately controlled with oral hypoglycemic agents. Other gliptins, notably vildagliptin (Galvus), saxagliptin and melogliptin are advanced in clinical development. This article reviews the current evidence on the effectiveness of gliptins and suggests several ways in which these agents could be used in diabetes treatment.