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The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes
Eun Yeong Choe, Yongin Cho, Younjeong Choi, Yujung Yun, Hye Jin Wang, Obin Kwon, Byung-Wan Lee, Chul Woo Ahn, Bong Soo Cha, Hyun Chul Lee, Eun Seok Kang
Diabetes Metab J. 2014;38(3):211-219.   Published online June 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.3.211
  • 5,529 View
  • 77 Download
  • 27 Web of Science
  • 25 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

We evaluated the effects of two dipeptidyl peptidase-4 (DPP-4) inhibitors, sitagliptin and vildagliptin, on metabolic parameters in patients with type 2 diabetes mellitus.

Methods

A total of 170 type 2 diabetes patients treated with sitagliptin or vildagliptin for more than 24 weeks were selected. The patients were separated into two groups, sitagliptin (100 mg once daily, n=93) and vildagliptin (50 mg twice daily, n=77). We compared the effect of each DPP-4 inhibitor on metabolic parameters, including the fasting plasma glucose (FPG), postprandial glucose (PPG), glycated hemoglobin (HbA1c), and glycated albumin (GA) levels, and lipid parameters at baseline and after 24 weeks of treatment.

Results

The HbA1c, FPG, and GA levels were similar between the two groups at baseline, but the sitagliptin group displayed a higher PPG level (P=0.03). After 24 weeks of treatment, all of the glucose-related parameters were significantly decreased in both groups (P=0.001). The levels of total cholesterol and triglycerides were only reduced in the vildagliptin group (P=0.001), although the sitagliptin group received a larger quantity of statins than the vildagliptin group (P=0.002).The mean change in the glucose- and lipid-related parameters after 24 weeks of treatment were not significantly different between the two groups (P=not significant). Neither sitagliptin nor vildagliptin treatment was associated with a reduction in the high sensitive C-reactive protein level (P=0.714).

Conclusion

Vildagliptin and sitagliptin exert a similar effect on metabolic parameters, but vildagliptin exerts a more potent beneficial effect on lipid parameters.

Citations

Citations to this article as recorded by  
  • Insulin Tregopil: An Ultra-Fast Oral Recombinant Human Insulin Analog: Preclinical and Clinical Development in Diabetes Mellitus
    Shashank Joshi, Vathsala Jayanth, Subramanian Loganathan, Vasan K. Sambandamurthy, Sandeep N. Athalye
    Drugs.2023; 83(13): 1161.     CrossRef
  • Efficacy and Safety of Treatment with Quadruple Oral Hypoglycemic Agents in Uncontrolled Type 2 Diabetes Mellitus: A Multi-Center, Retrospective, Observational Study
    Jun Sung Moon, Sunghwan Suh, Sang Soo Kim, Heung Yong Jin, Jeong Mi Kim, Min Hee Jang, Kyung Ae Lee, Ju Hyung Lee, Seung Min Chung, Young Sang Lyu, Jin Hwa Kim, Sang Yong Kim, Jung Eun Jang, Tae Nyun Kim, Sung Woo Kim, Eonju Jeon, Nan Hee Cho, Mi-Kyung Ki
    Diabetes & Metabolism Journal.2021; 45(5): 675.     CrossRef
  • Vasculoprotective Effects of Vildagliptin. Focus on Atherogenesis
    Michał Wiciński, Karol Górski, Eryk Wódkiewicz, Maciej Walczak, Magdalena Nowaczewska, Bartosz Malinowski
    International Journal of Molecular Sciences.2020; 21(7): 2275.     CrossRef
  • Anti-inflammatory properties of antidiabetic drugs: A “promised land” in the COVID-19 era?
    Niki Katsiki, Ele Ferrannini
    Journal of Diabetes and its Complications.2020; 34(12): 107723.     CrossRef
  • Effect of Switching from Linagliptin to Teneligliptin Dipeptidyl Peptidase-4 Inhibitors in Older Patients with Type 2 Diabetes Mellitus


    Eugene Han, Minyoung Lee, Yong-ho Lee, Hye Soon Kim, Byung-wan Lee, Bong-Soo Cha, Eun Seok Kang
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 4113.     CrossRef
  • Combined vildagliptin and memantine treatment downregulates expression of amyloid precursor protein, and total and phosphorylated tau in a rat model of combined Alzheimer’s disease and type 2 diabetes
    Samar S. Khalaf, Mohamed M. Hafez, Eman T. Mehanna, Noha M. Mesbah, Dina M. Abo-Elmatty
    Naunyn-Schmiedeberg's Archives of Pharmacology.2019; 392(6): 685.     CrossRef
  • Therapeutic experience of saxagliptin as first add-on after metformin in Indian type 2 diabetes patients: A non-interventional, prospective, observational study (ONTARGET-INDIA)
    Sanjay Kalra, Sarita Bajaj, AG Unnikrishnan, ManashP Baruah, Rakesh Sahay, V Hardik, Amit Kumar
    Indian Journal of Endocrinology and Metabolism.2019; 23(3): 312.     CrossRef
  • Cardiovascular Outcome Trials of the Incretin-Based Therapies: What Do We Know So Far?
    Pablo F. Mora, Eric L. Johnson
    Endocrine Practice.2017; 23(1): 89.     CrossRef
  • Treatment of Dyslipidemias to Prevent Cardiovascular Disease in Patients with Type 2 Diabetes
    Maryam Khavandi, Francisco Duarte, Henry N. Ginsberg, Gissette Reyes-Soffer
    Current Cardiology Reports.2017;[Epub]     CrossRef
  • Sodium butyrate has context-dependent actions on dipeptidyl peptidase-4 and other metabolic parameters
    Eun-Sol Lee, Dong-Sung Lee, Prakash Raj Pandeya, Youn-Chul Kim, Dae-Gil Kang, Ho-Sub Lee, Byung-Chul Oh, Dae Ho Lee
    The Korean Journal of Physiology & Pharmacology.2017; 21(5): 519.     CrossRef
  • Risk of Myopathy Associated With DPP-4 Inhibitors in Combination With Statins: A Disproportionality Analysis Using Data From the WHO and French Spontaneous Reporting Databases
    Vanessa Labat, Mickael Arnaud, Ghada Miremont-Salamé, Francesco Salvo, Bernard Bégaud, Antoine Pariente
    Diabetes Care.2017; 40(3): e27.     CrossRef
  • Soluble DPP-4 up-regulates toll-like receptors and augments inflammatory reactions, which are ameliorated by vildagliptin or mannose-6-phosphate
    Dong-Sung Lee, Eun-Sol Lee, Md. Morshedul Alam, Jun-Hyeog Jang, Ho-Sub Lee, Hyuncheol Oh, Youn-Chul Kim, Zahid Manzoor, Young-Sang Koh, Dae-Gil Kang, Dae Ho Lee
    Metabolism.2016; 65(2): 89.     CrossRef
  • A Multifactorial Approach to Reduce Cardiovascular Disease in Type 2 Diabetes Mellitus: Now More Than Ever
    Jan N. Basile
    Hospital Practice.2016; 44(1): 9.     CrossRef
  • Association between DPP4 gene polymorphism and serum lipid levels in Chinese type 2 diabetes individuals
    Xiaomin Xing, Yi Han, Xiaojun Zhou, Bo Zhang, Yan Li, Zhongsu Wang, Lin Liao, Lequn Su
    Neuropeptides.2016; 60: 1.     CrossRef
  • Common medications used by patients with type 2 diabetes mellitus: what are their effects on the lipid profile?
    Paul D. Rosenblit
    Cardiovascular Diabetology.2016;[Epub]     CrossRef
  • Dipeptidyl peptidase-4 inhibition and narrow-band ultraviolet-B light in psoriasis (DINUP): study protocol for a randomised controlled trial
    Maeve Lynch, Tomás B. Ahern, Irene Timoney, Cheryl Sweeney, Genevieve Kelly, Rosalind Hughes, Anne-Marie Tobin, Donal O’Shea, Brian Kirby
    Trials.2016;[Epub]     CrossRef
  • Efficacy of different dipeptidyl peptidase-4 (DPP-4) inhibitors on metabolic parameters in patients with type 2 diabetes undergoing dialysis
    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
    Medicine.2016; 95(32): e4543.     CrossRef
  • Incretin-based therapies for obesity treatment
    Aline Haas de Mello, Morgana Prá, Larissa Colonetti Cardoso, Rosiane de Bona Schraiber, Gislaine Tezza Rezin
    Metabolism.2015; 64(9): 967.     CrossRef
  • Brain Signaling Systems in the Type 2 Diabetes and Metabolic Syndrome: Promising Target to Treat and Prevent These Diseases
    Alexander O Shpakov, Kira V Derkach, Lev M Berstein
    Future Science OA.2015;[Epub]     CrossRef
  • Comparative analysis of therapeutic efficiency and costs (experience in Bulgaria) of oral antidiabetic therapies based on glitazones and gliptins
    Elena Pavlova Filipova, Katya Hristova Uzunova, Toni Yonkov Vekov
    Diabetology & Metabolic Syndrome.2015;[Epub]     CrossRef
  • Antidiabetic Effect of Galantamine: Novel Effect for a Known Centrally Acting Drug
    Mennatallah A. Ali, Hanan S. El-Abhar, Maher A. Kamel, Ahmed S. Attia, John Calvert
    PLOS ONE.2015; 10(8): e0134648.     CrossRef
  • The Nonglycemic Actions of Dipeptidyl Peptidase-4 Inhibitors
    Na-Hyung Kim, Taeyang Yu, Dae Ho Lee
    BioMed Research International.2014; 2014: 1.     CrossRef
  • A Post Hoc Analysis of HbA1c, Hypoglycemia, and Weight Change Outcomes with Alogliptin vs Glipizide in Older Patients with Type 2 Diabetes
    Morgan Bron, Craig Wilson, Penny Fleck
    Diabetes Therapy.2014; 5(2): 521.     CrossRef
  • Response: The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes (Diabetes Metab J2014;38:211-9)
    EunYeong Choe, Eun Seok Kang
    Diabetes & Metabolism Journal.2014; 38(4): 319.     CrossRef
  • Letter: The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes (Diabetes Metab J2014;38:211-9)
    Seung-Hwan Lee
    Diabetes & Metabolism Journal.2014; 38(4): 317.     CrossRef
Glycemic Effectiveness of Metformin-Based Dual-Combination Therapies with Sulphonylurea, Pioglitazone, or DPP4-Inhibitor in Drug-Naïve Korean Type 2 Diabetic Patients
Young Ki Lee, Sun Ok Song, Kwang Joon Kim, Yongin Cho, Younjeong Choi, Yujung Yun, Byung-Wan Lee, Eun-Seok Kang, Bong Soo Cha, Hyun Chul Lee
Diabetes Metab J. 2013;37(6):465-474.   Published online December 12, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.6.465
  • 5,978 View
  • 79 Download
  • 18 Crossref
AbstractAbstract PDFPubReader   
Background

This study compared the glycemic effectiveness of three metformin-based dual therapies according to baseline hemoglobin A1c (HbA1c) to evaluate the appropriateness of the guideline enforced by the National Health Insurance Corporation of Korea for initial medication of type 2 diabetes (T2D).

Methods

This prospective observational study was conducted across 24 weeks for drug-naïve Korean T2D patients with HbA1c greater than 7.5%. Subjects were first divided into three groups based on the agent combined with metformin (group 1, gliclazide-modified release or glimepiride; group 2, pioglitazone; group 3, sitagliptin). Subjects were also classified into three categories according to baseline HbA1c (category I, 7.5%≤HbA1c<9.0%; category II, 9.0%≤HbA1c<11.0%; category III, 11.0%≤HbA1c).

Results

Among 116 subjects, 99 subjects completed the study, with 88 subjects maintaining the initial medication. While each of the metformin-based dual therapies showed a significant decrease in HbA1c (group 1, 8.9% to 6.4%; group 2, 9.0% to 6.6%; group 3, 9.3% to 6.3%; P<0.001 for each), there was no significant difference in the magnitude of HbA1c change among the groups. While the three HbA1c categories showed significantly different baseline HbA1c levels (8.2% vs. 9.9% vs. 11.9%; P<0.001), endpoint HbA1c was not different (6.4% vs. 6.6% vs. 6.0%; P=0.051).

Conclusion

The three dual therapies using a combination of metformin and either sulfonylurea, pioglitazone, or sitagliptin showed similar glycemic effectiveness among drug-naïve Korean T2D patients. In addition, these regimens were similarly effective across a wide range of baseline HbA1c levels.

Citations

Citations to this article as recorded by  
  • Benefits and risks of drug combination therapy for diabetes mellitus and its complications: a comprehensive review
    Xueqin Xie, Changchun Wu, Yuduo Hao, Tianyu Wang, Yuhe Yang, Peiling Cai, Yang Zhang, Jian Huang, Kejun Deng, Dan Yan, Hao Lin
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Estimation of Serum Creatinine, Aspartate Aminotransferase, Alanine Transaminase, and Hemoglobin A1c% Levels among Diabetic Patients using Metformin/Dipeptide Peptidase-4 Inhibitor Combination and Insulin – A Cross-Sectional Study
    Arshiya Shadab, Ilma Hussain, Praveen Kumar Kandakurti, Marwan Ismail, Ahmed Luay Osman Hashim, Salah Eldin Omar Hussein, Altoum Abd Elgadir
    Open Access Macedonian Journal of Medical Sciences.2022; 10(B): 959.     CrossRef
  • Acarbose Add-on Therapy in Patients with Type 2 Diabetes Mellitus with Metformin and Sitagliptin Failure: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study
    Hae Kyung Yang, Seung-Hwan Lee, Juyoung Shin, Yoon-Hee Choi, Yu-Bae Ahn, Byung-Wan Lee, Eun Jung Rhee, Kyung Wan Min, Kun-Ho Yoon
    Diabetes & Metabolism Journal.2019; 43(3): 287.     CrossRef
  • Initial combination therapy with vildagliptin plus metformin in drug-naïve patients with T2DM: a 24-week real-life study from Asia
    Manoj Chawla, Tae Ho Kim, Roberto C. Mirasol, Pathan Faruque, Kathryn Cooke, Peggy Hours-Zesiger, Abhijit Shete
    Current Medical Research and Opinion.2018; 34(9): 1605.     CrossRef
  • Consensus recommendations on sulfonylurea and sulfonylurea combinations in the management of Type 2 diabetes mellitus – International Task Force
    Sanjay Kalra, Silver Bahendeka, Rakesh Sahay, Sujoy Ghosh, Fariduddin Md, Abbas Orabi, Kaushik Ramaiya, Sameer Al Shammari, Dina Shrestha, Khalid Shaikh, Sachitha Abhayaratna, PradeepK Shrestha, Aravinthan Mahalingam, Mazen Askheta, AlyAhmed A. Rahim, Fat
    Indian Journal of Endocrinology and Metabolism.2018; 22(1): 132.     CrossRef
  • Efficacy and safety of sitagliptin/metformin fixed‐dose combination compared with glimepiride in patients with type 2 diabetes: A multicenter randomized double‐blind study
    Sang Soo Kim, In Joo Kim, Kwang Jae Lee, Jeong Hyun Park, Young Il Kim, Young Sil Lee, Sung Chang Chung, Sang Jin Lee
    Journal of Diabetes.2017; 9(4): 412.     CrossRef
  • Short‐term intensive insulin therapy could be the preferred option for new onset Type 2 diabetes mellitus patients with HbA1c > 9%
    Jianping Weng
    Journal of Diabetes.2017; 9(10): 890.     CrossRef
  • The efficacy and safety of adding either vildagliptin or glimepiride to ongoing metformin therapy in patients with type 2 diabetes mellitus
    Gyuri Kim, Sewon Oh, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim, Moon-Kyu Lee
    Expert Opinion on Pharmacotherapy.2017; 18(12): 1179.     CrossRef
  • Effects of pioglitazone therapy on blood parameters, weight and BMI: a meta-analysis
    Elena Filipova, Katya Uzunova, Krassimir Kalinov, Toni Vekov
    Diabetology & Metabolic Syndrome.2017;[Epub]     CrossRef
  • Is insulin the preferred treatment for HbA1c >9%?
    Zachary Bloomgarden
    Journal of Diabetes.2017; 9(9): 814.     CrossRef
  • Effectiveness of sitagliptin compared to sulfonylureas for type 2 diabetes mellitus inadequately controlled on metformin: a systematic review and meta-analysis
    Manuj Sharma, Nicholas Beckley, Irwin Nazareth, Irene Petersen
    BMJ Open.2017; 7(10): e017260.     CrossRef
  • The effect of pioglitazone on weight, lipid profile and liver enzymes in type 2 diabetic patients
    Nasser Aghamohammadzadeh, Mitra Niafar, Elham Dalir Abdolahinia, Farzad Najafipour, Saeed Mohamadzadeh Gharebaghi, Khadijeh Adabi, Elaheh Dalir Abdolahinia, Hamidreza Ahadi
    Therapeutic Advances in Endocrinology and Metabolism.2015; 6(2): 56.     CrossRef
  • Glycated Albumin Levels in Patients with Type 2 Diabetes Increase Relative to HbA1cwith Time
    Hye-jin Yoon, Yong-ho Lee, Kwang Joon Kim, So Ra Kim, Eun Seok Kang, Bong-Soo Cha, Hyun Chul Lee, Byung-Wan Lee
    BioMed Research International.2015; 2015: 1.     CrossRef
  • Four-Year Durability of Initial Combination Therapy with Sitagliptin and Metformin in Patients with Type 2 Diabetes in Clinical Practice; COSMIC Study
    Eu Jeong Ku, Kyong Yeon Jung, Yoon Ji Kim, Kyoung Min Kim, Jae Hoon Moon, Sung Hee Choi, Young Min Cho, Kyong Soo Park, Hak Chul Jang, Soo Lim, Bo Ahrén, Giorgio Sesti
    PLOS ONE.2015; 10(6): e0129477.     CrossRef
  • Comparative analysis of therapeutic efficiency and costs (experience in Bulgaria) of oral antidiabetic therapies based on glitazones and gliptins
    Elena Pavlova Filipova, Katya Hristova Uzunova, Toni Yonkov Vekov
    Diabetology & Metabolic Syndrome.2015;[Epub]     CrossRef
  • Interactions of DPP-4 and integrin β1 influences endothelial-to-mesenchymal transition
    Sen Shi, Swayam Prakash Srivastava, Megumi Kanasaki, Jianhua He, Munehiro Kitada, Takako Nagai, Kyoko Nitta, Susumu Takagi, Keizo Kanasaki, Daisuke Koya
    Kidney International.2015; 88(3): 479.     CrossRef
  • Sodium Glucose Co-transporter 2 (SGLT2) Inhibitors: New among Antidiabetic Drugs
    L. H. Opie
    Cardiovascular Drugs and Therapy.2014; 28(4): 331.     CrossRef
  • Metformin Based Dual-Combination Therapies in Drug Naïve Type 2 Diabetic Patients
    Dong-Lim Kim
    Diabetes & Metabolism Journal.2013; 37(6): 429.     CrossRef

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