Dipeptidyl Peptidase-4 inhibitors use in type II diabetic patients in a tertiary hospital (original) (raw)
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2021
Background and Aims: Oral antidiabetic drugs, including Dipeptidyl Peptidase 4 Inhibitors (DPP4i), are the mainstay for therapeutic management of type 2 diabetes mellitus (T2DM). We aimed to describe the prescribing pattern of DPP4i agents and to assess the achievement of the target HbA1c levels among current DPP4i users at a Malaysian University teaching hospital. Material and Method: A retrospective cross-sectional study was conducted in the outpatient diabetes clinic of a university teaching hospital in Pahang, Malaysia. The data included adults with T2DM who received DPP4i prescriptions at least three months before December 2019 and reported data of HbA1c after at least three months from the index date. Evaluation of the DPP4i prescribing patterns referred to the national clinical practice guidelines. Results: 140 cases were included. Sitagliptin 50 mg is the most commonly prescribed DPP4i regimen (72.1%), and its combination therapy with metformin contributed to 67.1% of the to...
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.
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.
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.
A Comparative Study on Management of Diabetes Mellitus Relation to Dipeptidyl Peptidase-4 Inhibitors
Background: The incidence of Diabetes Mellitus has increased dramatically in recent decades. Di Peptidyl Peptidase 4 inhibitors (DPP-4) have their role in glycemic control. An impaired 'incretin effect', occurs in patients with type 2 Diabetes Mellitus in response to glucose intake. Objectives: The main objective of the study is to compare therapeutic outcomes and adverse drug reactions among commonly prescribed anti diabetic drug combinations in adults with type 2 diabetes mellitus. Methodology: A retrospective and prospective study experimental study was carried out for a period of one year at care diabetes centre, Warangal, Telangana. Results: FBS and PLBS were found to be significantly lower in DPP group when compared with SU and TZ. Adverse events such as itching, abdominal pain, constipation and weight loss are more in DPP when compared with other groups. Data from this study indicated thatDPP-4 inhibitors are superior to sulfonylureas (SU) and thiazolidinediones (TZ) when used in combination with metformin (B) in glycemic control. Conclusion: DPP inhibitors provide an effective therapeutic option for individuals with Type 2 Diabetes along with obesity.
International Journal of Endocrinology, 2014
Dipeptidyl-4 (DPP-4) inhibitors are oral antidiabetic agents recently introduced to Malaysia. Thus, limited data is available on their utilization patterns and factors associated with their use. This study aims to analyse the utilization patterns of DPP-4 inhibitors, factors that influenced the choice of agent, and the rationale for treatment with DPP-4 inhibitors in patients with type 2 diabetes mellitus. This retrospective study was conducted to address the utilization pattern of DPP-4 inhibitors and factors that influence choice in type 2 diabetes mellitus patients. 299 subjects taking either sitagliptin or vildagliptin from September 2008 to September 2012 were included in the study. Sitagliptin was more frequently prescribed than vildagliptin. Of the patients prescribed DPP-4 inhibitors, 95% received combinations of these and other agents, whereas only 5% were prescribed DPP-4 inhibitors as monotherapy. Factors affecting the utilization of DPP-4 inhibitors included age(P=0.049)...
Diabetes Therapy
Introduction: The use of antihyperglycemic agents (AHA), especially insulin and sulfonylureas (SU), is a risk factor for hypoglycemia. Despite the significant clinical and economic burdens associated with hypoglycemia and the decreasing use of SU in favor of other oral AHA, relatively little is known about hypoglycemia trends specific to the use of non-insulin AHA. We sought to estimate annual hypoglycemia event rates and costs among patients with type 2 diabetes mellitus (T2DM) who started either SU or dipeptidyl peptidase-4 inhibitors (DPP-4i) and to predict rates and costs in the absence of DPP-4i. Methods: Truven's MarketScan Commercial Claims database was used to estimate hypoglycemia event rates and costs from 2007 to 2013. Hypoglycemia, defined using diagnosis codes, was assessed during the 12 months following SU (n = 245,201) or DPP-4i (n = 176,786) initiation by adults with T2DM. Coefficients from a Poisson regression model used to estimate the impact of patient characteristics on hypoglycemia rates for patients who started SU were used to predict rates for patients who started DPP-4i had they started SU instead. Results: Hypoglycemia events per 100 patientyears (costs per event) ranged from 5.4 ($565) in 2007 to 10.4 ($1154) in 2013 for patients starting SU; rates (costs) for patients starting DPP-4i ranged from 3.2 ($308) in 2007 to 6.4 ($482) in 2013. Predicted hypoglycemia rates would have been 5.3-9.9 per 100 person-years for patients who started DPP-4i had they started SU instead. Starting DPP-4i, rather than SU, would have resulted in national savings of $750.3 million in healthcare costs due to avoided hypoglycemia events during this period. Conclusions: Hypoglycemia rates and costs were consistently higher for patients who started SU rather than DPP-4i. The overall burden of hypoglycemia could be lowered substantially in the USA if, when feasible, patients with T2DM initiate DPP-4i instead of SU.