EFFICACY AND SAFETY OF ADDING SITAGLIPTIN TO BASAL INSULIN THERAPY

Yıl 2024, Cilt: 2 Sayı: 3, 8 - 12, 10.11.2024

Sakin Tekin , Mehmet Sargın

Öz

ABSTRACT
Background: Some of the options where blood glucose regulation cannot be achieved with basal insulin - oral antidiabetic pheasant is the addition of sitagliptin, a dipeptidyl peptidase 4 (DPP-4) inhibitor, to the treatment. This is what writes on glycemic control and body writing and prompting for the addition of sitagliptin to basal insulin therapy with metformin and / or other oral antidiabetics.
Methods: The study included 52 patients who had been on sitagliptin and sitagliptin for at least 3 months on basal insulin therapy with metformin and / or other oral antidiabetic agents. Anthopometric and clinical features such as age, gender, BMI and FBG, HbA1c and other metabolic parameters were examined.
Results: The average age of 43 patients, 29 (67.5%) female and 14 (32.5%) males, was 54.3 and their body mass index was 34.8 kg / m2 at the beginning of the treatment. It was determined that the mean HbA1c levels, which were 9.1 ± 1.5% at the beginning, decreased to 8.2 ± 1.7% by decreasing 0.89% in the 3rd month after sitagliptin was added to the treatment (p <0.05). It was observed that the fasting blood glucose, which was 203.9 ± 76.2 at the beginning, decreased by 34.2 ± 74.9 mg / dl in the 3rd month with the addition of sitagliptin to the treatment (p <0.05). There was no significant change in patients' body weight; no serious adverse effects or severe hypoglycemia attack was detected.
Conclusion: The addition of sitagliptin to the treatment where adequate glycemic control cannot be achieved with metformin and / or other oral antidiabetic and basal insulin is an effective and good option.

Anahtar Kelimeler

Diabetes, treatment, sitagliptin, basal insulin theraphy

BAZAL İNSÜLİN TEDAVİSİNE SİTAGLİPTİN EKLENMESİNİN ETKİNLİK VE GÜVENLİLİĞİ

Öz

Background: Some of the options where blood glucose regulation cannot be achieved with basal insulin - oral antidiabetic pheasant is the addition of sitagliptin, a dipeptidyl peptidase 4 (DPP-4) inhibitor, to the treatment. This is what writes on glycemic control and body writing and prompting for the addition of sitagliptin to basal insulin therapy with metformin and / or other oral antidiabetics.
Methods: The study included 52 patients who had been on sitagliptin and sitagliptin for at least 3 months on basal insulin therapy with metformin and / or other oral antidiabetic agents. Anthopometric and clinical features such as age, gender, BMI and FBG, HbA1c and other metabolic parameters were examined.
Results: The average age of 43 patients, 29 (67.5%) female and 14 (32.5%) males, was 54.3 and their body mass index was 34.8 kg / m2 at the beginning of the treatment. It was determined that the mean HbA1c levels, which were 9.1 ± 1.5% at the beginning, decreased to 8.2 ± 1.7% by decreasing 0.89% in the 3rd month after sitagliptin was added to the treatment (p <0.05). It was observed that the fasting blood glucose, which was 203.9 ± 76.2 at the beginning, decreased by 34.2 ± 74.9 mg / dl in the 3rd month with the addition of sitagliptin to the treatment (p <0.05). There was no significant change in patients' body weight; no serious adverse effects or severe hypoglycemia attack was detected.
Conclusion: The addition of sitagliptin to the treatment where adequate glycemic control cannot be achieved with metformin and / or other oral antidiabetic and basal insulin is an effective and good option.

Anahtar Kelimeler

Diabetes, treatment, sitagliptin, basal insulin theraphy

Kaynakça

• 1. Hemmingsen B, Lund SS, Gluud C, et al. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus. Cochrane Database Syst Rev 2011; :CD008143.
• 2. Selvin E, Marinopoulos S, Berkenblit G, et al. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med 2004; 141:421
• 3. Hermansen K, Davies M, Derezinski T, Martinez RG, Clauson P, Home P. A 26-week, randomized, parallel, treat-to-target trial comparing insulin detemir with NPH insulin as add-on therapy to oral glucose-lowering drugs in insulin-naive people with type 2 diabetes. Diabetes Care 2006;29: 1269–1274
• 4. Yki-Jarvinen H, Kauppinen-Makelin R, Tiikkainen M et al. Insulin glargine or NPH combined with metformin in type 2 diabetes: the LANMET study. Diabetologia 2006; 49: 442–451.
• 5. Davies M, Storms F, Shutler S, Bianchi-Biscay M, Gomis R. Improvement of glycemic control in subjects with poorly controlled type 2 diabetes: comparison of two treatment algorithms using insulin glargine. Diabetes Care 2005; 28: 1282–1288
• 6. Kennedy L, Herman WH, Strange P, Harris A. Impact of active versus usual algorithmic titration of basal insulin and point-of-care versus laboratory measurement of HbA1c on glycemic control in patients with type 2 diabetes: the Glycemic Optimization with Algorithms and Labs at Point of Care (GOAL A1C) trial. Diabetes Care 2006; 29: 1–8.
• 7. Guler S, Vaz JA, Ligthelm R. Intensification lessons with modern premixes: from clinical trial to clinical practice. Diabetes Res Clin Pract 2008; 81(Suppl.1): S23–S30.
• 8. Korytkowski M. When oral agents fail: practical barriers to starting insulin. Int J Obes Relat Metab Disord 2002; 26(Suppl. 3): S18–S24.
• 9. Dhillon S. Sitagliptin: a review of its use in the management of type 2 diabetes mellitus. Drugs. 2010;70(4):489–512.
• 10. Plosker GL. Sitagliptin: a review of its use in patients with type 2 diabetes mellitus. Drugs. 2014;74(2):223–42.
• 11. Lyseng-Williamson KA. Sitagliptin. Drugs. 2007;67(4):587–97.
• 12. Vilsbøll T, Rosenstock J, Yki-Ja¨rvinen H, et al. Efficacy and safety of sitagliptin when added to insulin therapy in patients with type 2 diabetes. Diabetes Obes Metab. 2010;12(2):167–77.
• 13. Mathieu C, Shankar RR, Lorber D, et al. A randomized clinical trial to evaluate the efficacy and safety of co-administration of sitagliptin with intensively titrated insulin glargine. Diabetes Ther. 2015;6(2):127–42.