A Comparative Study on Management of Diabetes Mellitus Relation to Dipeptidyl Peptidase-4 Inhibitors (original) (raw)
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Context: clinical outcomes of Dipeptidyl Peptidase-4 inhibitors can be beneficial for the patients in controlling high blood sugar it can also cause potential adverse effects Aim: The main objective of this study was to assess the risks and benefits of Dipeptidyl peptidase-4inhibitors (DPP-4I) in type 2 diabetes mellitus patients. Method: systematical articles on Dipeptidyl peptidase-4 inhibitors were reviewed from the year 2015 up to 2017 from 3 databases such as: EMBASE, COCHRANE and MEDSCAPE and some diabetes associations, the main such were: DPP-4 inhibitor, incretin, type 2 diabetes mellitus, Vildagliptin, Sitagliptin, Linagliptin, Saxagliptin, Alogliptin, 69 citations were included after screening for duplication and biased articles. Results: All DPP-4I are efficacious for improving blood glucose level among type 2 diabetes mellitus patients without causing hypoglycemic effects, and they can be used as monotherapy or in combination with other antidiabetic agents, Linagliptin offer uniqueness properties due to its non-renal excretion it improves microalbuminuria, whereas remaining DDP-4I cause a marginal changes on renal function, there is no hepatotoxicity among the DPP-4I no dose adjustment for Linagliptin, Sitagliptin, saxagliptin due non-hepatic excretion, only dose reduction is required for patients with minor hepatic functional impairment taking Vildagliptin and saxagliptin due to their partially elimination via liver,DPP-4I also protect patients for cardiovascular complications due its ability of reducing or maintaining the stability of body weight and lipid profile. They also show a low risk for increasing pancreatitis among T2DM and the others side effect were comparable less when compared to other anti-hyperglycemic agents. Conclusion: DPP-4I significantly control blood sugar level by decreasing glycated hemoglobin, fasting blood sugar, random blood sugar and they are not associated with hypoglycemic events they also minimize cardiovascular complications by reducing fats and weight in type 2 diabetes mellitus patients, in addition DPP-4I helps in renal and liver protection. Over all, DPP-4I reduce morbidity and mortality rate among T2DM patients.
Background: Diabetes is a chronic metabolic disease which affects the quality of life. It leads to multiple complications due to metabolic involvement. Out of multiple drugs used to treat diabetes, dipeptidyl peptidase 4 (DPP-4) inhibitors are comparatively new drugs used for type-2-diabetes mellitus (DM) treatment. This study aimed to find out the drug utilization (DU) 90% and use of DPP-4 inhibitors in patients with type-2-DM. Methods: A prospective, cross-sectional, observational study was conducted at a private healthcare clinic of an endocrinologist in Nashik. Type-2-DM patients of both sexes were selected and a total of 199 patients were enrolled in the study. The consented patients were interviewed and prescription copies were collected. After studying them; statistical analysis was done and results and conclusions were drawn. Results: Out of total prescribed drugs, 58.77% of drugs were anti-diabetics. It was observed that the biguanides were most frequently (25.32%) prescribed while the least prescribed drugs were meglitinide analogues (0.08%). Most commonly utilized anti-diabetic found to be metformin. Vildagliptin 50 mg is the most commonly prescribed drug from DPP-4 inhibitors. Most of the drugs from the DPP-4 inhibitor group came under DU90%. Conclusions: DPP-4 inhibitors are showing wide acceptability by endocrinologists for type-2-DM management, according to this study. Performing repetitive drug utilization pattern study and circulation of standard treatment guidelines to practising physicians can be required. To emphasize the point on generic prescription, more awareness should be created. So that these can responses to further cost-effective and rational prescribing practices.
Dipeptidyl Peptidase-4 inhibitors use in type II diabetic patients in a tertiary hospital
2020
Background In Malaysia, for more than a decade, dipeptidyl peptidase-4 inhibitors (DPP-4i) are among the oral antidiabetic medications used as monotherapy or in combination to manage type II diabetes mellitus (T2DM). These medications are known for the efficacy in glycated haemoglobin (HbA1c) reduction and weight neutral effect with minimal hypoglycaemia occurrence. This study aimed to identify the outcomes of DPP-4i use in one of the largest tertiary public hospital in Southeast Asia. Methods This is a retrospective cross sectional study conducted in 2016, where stratified sampling method was used. Patients with T2DM treated with available DPP-4i; namely Linagliptin, Saxagliptin, Sitagliptin and Vildagliptin, for at least 3 months were identified from the pharmacy record. Medical records from Physician Clinic in Hospital Kuala Lumpur (HKL) were reviewed. Data on demographic, anthropometric, antidiabetic treatment modalities, laboratory and documented outcomes were collected. Outcom...
International Journal of Basic & Clinical Pharmacology, 2019
Background: Diabetes is a chronic metabolic disease which affects the quality of life. It leads to multiple complications due to metabolic involvement. Out of multiple drugs used to treat diabetes, dipeptidyl peptidase 4 (DPP-4) inhibitors are comparatively new drugs used for type-2-diabetes mellitus (DM) treatment. This study aimed to find out the drug utilization (DU) 90% and use of DPP-4 inhibitors in patients with type-2-DM. Methods: A prospective, cross-sectional, observational study was conducted at a private healthcare clinic of an endocrinologist in Nashik. Type-2-DM patients of both sexes were selected and a total of 199 patients were enrolled in the study. The consented patients were interviewed and prescription copies were collected. After studying them; statistical analysis was done and results and conclusions were drawn. Results: Out of total prescribed drugs, 58.77% of drugs were anti-diabetics. It was observed that the biguanides were most frequently (25.32%) prescribed while the least prescribed drugs were meglitinide analogues (0.08%). Most commonly utilized anti-diabetic found to be metformin. Vildagliptin 50 mg is the most commonly prescribed drug from DPP-4 inhibitors. Most of the drugs from the DPP-4 inhibitor group came under DU90%. Conclusions: DPP-4 inhibitors are showing wide acceptability by endocrinologists for type-2-DM management, according to this study. Performing repetitive drug utilization pattern study and circulation of standard treatment guidelines to practising physicians can be required. To emphasize the point on generic prescription, more awareness should be created. So that these can responses to further cost-effective and rational prescribing practices.
Journal of Pharmaceutical Research International, 2021
There is a significant increase noted in the incidence and prevalence of Type 2 diabetes mellitus (T2DM). The global number of diabetic patients is projected by the International Diabetes Federation (IDF) to reach 552 million. T2DM disease has chronic and progressive nature. More than fifty percent of patients do not attain adequate glycemic control despite initial sufficient monotherapy. To maintain target glycated hemoglobin (HbA1c) levels (<7%), dose adjustment and adoption of several diabetes therapies become necessary in many cases. Compared to monotherapy, a fixed drug combination of oral agents and metformin has proven to be more efficacious to maintain levels of blood glucose and HbA1c. The combination of dipeptidyl peptidase-4 inhibitors (DDPIs) and metformin has been explicated to effectively decrease HbA1c to a relatively higher degree compared to the use of either agent individually. This combination addresses various pathophysiological processes involved in T2DM path...
Dipeptidyl Peptidase-4 Inhibitors, a New Option for the Management of Type 2 Diabetes Mellitus
Romanian Journal of Diabetes Nutrition and Metabolic Diseases, 2012
Objective: Despite the diversity of antidiabetic medication currently available, lessthan half of the patients with type 2 diabetes meet the therapeutic targetsrecommended by the guidelines: HbA1c <7%, or even <6.5%. This study aimed toinvestigate the efficacy and safety of sitagliptin in patients with type 2 diabetesmellitus, with inadequate glycemic control, as well as the effects on cardiovascularrisk factors. Material and method: The study included 348 patients, 161 men(46.3%) and 187 women (53.7%), with mean age of 56.1 ± 6.2 years, who startedtreatment with sitagliptin, combined with either metformin, sulphonylurea or both.Results and discussions: Sitagliptin improved glycemic control reducing averageHbA1c with 1.1%; the average weight decreased with 1.7 kg after 24 weeks oftreatment, and the lipid profile improved significantly. Conclusions: Sitagliptinoffers a new therapeutic option in patients with type 2 diabetes mellitus, with theadvantage of a single dose oral admi...
Journal of Universal College of Medical Sciences
INTRODUCTIONDiabetes is a metabolic disorder marked by high blood glucose levels, and treatment often requires multiple drugs to achieve adequate glycemic control. In individuals with type 2 diabetes mellitus who do not respond to Metformin, doctors may prescribe a Dipeptidyl Peptidase-4 inhibitor or a Sulphonylurea as potential add-on therapy. The study was conducted to compare the efficacy and safety of the Dipeptidyl Peptidase-4 inhibitor with Sulphonylurea. MATERIAL AND METHODSThis was an interventional, comparative study involving 100 type 2 diabetic patients who visited the Medicine department at Universal college of Medical Sciences. All the eligible patients were randomly divided into two treatment groups (50 each): Group A (Sulphonylurea + Metformin) and Group B (Dipeptidyl Peptidase-4 inhibitor + Metformin). Treatment was provided for 18 weeks, and patients were investigated for blood glucose parameters like glycosylated hemoglobin, fasting blood glucose, postprandial gluc...
Clinical and Investigative Medicine, 2016
The purpose of this study was to compare the safety and efficacy of DPP-4 inhibitors versus sulfonylurea as adjunctive second-line therapy in patients with type 2 diabetes mellitus, inadequately controlled with metformin mono-therapy. A systematic review of published randomized controlled trials (RCTs) was performed in MEDLINE, EMBASE, PubMed and Cochrane library. Two reviewers independently selected the studies, extracted the data and assessed the risk of bias. Clinical outcomes were cardiovascular events, HbA1c % change from baseline, body weight and hypoglycemic event rate. A direct comparison meta-analysis using a random effect model was conducted to calculate mean differences in treatment effects and risk ratio between DPP-4 inhibitors and sulfonylurea. Ten RCTs on adult patients with type 2 diabetes and inadequate glycemic control were included in the final analysis. DPP-4 inhibitors compared to sulfonylureas produced a non-significant difference in HbA1c% change in 10,139 sub...
Journal of diabetes research, 2015
Incretin-based therapies, the most recent therapeutic options for type 2 diabetes mellitus (T2DM) management, can modify various elements of the disease, including hypersecretion of glucagon, abnormal gastric emptying, postprandial hyperglycaemia, and, possibly, pancreatic β cell dysfunction. Dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) increase glucagon-like peptide-1 (GLP-1) availability and correct the "incretin defect" seen in T2DM patients. Clinical studies have shown good glycaemic control with minimal risk of hypoglycaemia or any other adverse effects, despite the reports of pancreatitis, whose association remains to be proved. Recent studies have been focusing on the putative ability of DPP-4 inhibitors to preserve pancreas function, in particular due to the inhibition of apoptotic pathways and stimulation of β cell proliferation. In addition, other cytoprotective effects on other organs/tissues that are involved in serious T2DM complications, including the...