The dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin improves glycemic control in type 2 diabetic patients undergoing hemodialysis

Midori Ito; Masanori Abe; Kazuyoshi Okada; Hirokazu Sasaki; Noriaki Maruyama; Masaaki Tsuchida; Terumi Higuchi; Fumito Kikuchi; Masayoshi Soma

doi:10.1507/endocrj.EJ11-0025

ORIGINALS

The dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin improves glycemic control in type 2 diabetic patients undergoing hemodialysis

Midori Ito, Masanori Abe, Kazuyoshi Okada, Hirokazu Sasaki, Noriaki Maruyama, Masaaki Tsuchida, Terumi Higuchi, Fumito Kikuchi, Masayoshi Soma

Author information

Midori Ito
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
Masanori Abe
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
Kazuyoshi Okada
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
Hirokazu Sasaki
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
Noriaki Maruyama
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
Department of Internal Medicine, Nihon University Nerima Hikarigaoka Hospital, Tokyo, Japan
Masaaki Tsuchida
Tobu Nerima Clinic, Tokyo, Japan
Terumi Higuchi
Keiai Hospital, Department of Nephrology, Tokyo, Japan
Fumito Kikuchi
Meirikai Chuo General Hospital, Department of Nephrology, Tokyo, Japan
Masayoshi Soma
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan

Keywords: Dipeptidyl peptidase-4 (DPP-4) inhibitor, Glycemic control, Hemodialysis, Type-2 diabetes, Vildagliptin

JOURNAL FREE ACCESS

2011 Volume 58 Issue 11 Pages 979-987

DOI https://doi.org/10.1507/endocrj.EJ11-0025

View "Advance Publication" version (September 15, 2011).

Details

Abstract

The potent and selective dipeptidyl peptidase-4 inhibitor vildagliptin improves glycemic control in patients with type 2 diabetes through incretin hormone-mediated increases in both α- and β-cell responsiveness to glucose. We conducted a prospective, open-label, parallel group, controlled study of 51 patients with type 2 diabetic patients undergoing hemodialysis (HD) during the 24-week study period. Patients were assigned to two groups: the vildagliptin group (n = 30) and the control group (n = 21). Vildagliptin was administered at 50 mg/day for the first 8 weeks. Then doses were titrated by dose-doubling to a maximum of 100 mg/day if hemoglobin A1c (HbA1c) or glycated albumin (GA) target levels had not been reached. No vildagliptin was administered to the controls. The average final dose of vildagliptin was 80 ± 5 mg daily. After 24 weeks, vildagliptin had decreased average HbA1c levels from 6.7 % baseline to 6.1 %, average GA levels from 24.5 % baseline to 20.5 % and average postprandial plasma glucose levels from 186 mg/dL baseline to 140 mg/dL (all p < 0.0001). In the control group, we observed no such changes. Vildagliptin efficacy did not differ according to age or body mass index, but the GA reduction was significantly greater in the anti-diabetic agents-naïve group. Furthermore, in patients with higher baseline GA levels, a higher vildagliptin dosage was required to produce a noticeable effect. No serious adverse effects such as hypoglycemia or liver impairment were observed in any patient. Vildagliptin was effective as a treatment for diabetic patients undergoing HD.

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