C-Peptide Levels Predict the Effectiveness of Dipeptidyl Peptidase-4 Inhibitor Therapy.
Sevin DemirŞule TemizkanMehmet SarginPublished in: Journal of diabetes research (2016)
Background. Our aim was to define the conditions that affect therapeutic success when dipeptidyl peptidase-4 (DPP-4) inhibitor is added to metformin monotherapy. Materials and Methods. We reviewed the medical records of 56 patients who had received DPP-4 inhibitor as an add-on to metformin monotherapy and evaluated their response in the first year of therapy. Fasting blood glucose (FBG), HbA1c, C-peptide, and weight of the patients were recorded at 3-month intervals during the first year of treatment. Results. Patients who added DPP-4 inhibitor to metformin monotherapy had significant weight loss (P = 0.004) and FBG and HbA1c levels were significantly lowered during the first 6 months (both P < 0.001). Baseline levels of C-peptide were predictive for success of the treatment (P = 0.02), even after correction for confounding factors, for example, age, gender, or BMI (P = 0.03). Duration of diabetes was not a predictor of response to treatment (P = 0.60). Conclusion. Our study demonstrates that in patients having inadequate glycemic control, the addition of a DPP-4 inhibitor as a second oral agent to metformin monotherapy provides better glycemic control, protects β-cell reserves, and does not cause weight gain. These effects depend on baseline C-peptide levels.
Keyphrases
- glycemic control
- blood glucose
- weight loss
- type diabetes
- weight gain
- combination therapy
- body mass index
- end stage renal disease
- newly diagnosed
- bariatric surgery
- randomized controlled trial
- ejection fraction
- chronic kidney disease
- open label
- prognostic factors
- insulin resistance
- systematic review
- cell therapy
- roux en y gastric bypass
- mesenchymal stem cells
- stem cells
- adipose tissue
- gastric bypass
- skeletal muscle
- preterm birth