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Effect of sitagliptin on glucose control in adult patients with Type 1 diabetes: a pilot, double-blind, randomized, crossover trial.
MedLine Citation:
PMID:  21923696     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Diabet. Med. 28, 1176-1181 (2011) ABSTRACT: Aims  Patients with Type 1 diabetes have significantly elevated postprandial glucagon secretion. Dipeptidyl peptidase IV inhibitors improve HbA(1c) by several mechanisms, including increasing glucagon-like peptide 1 and glucose-dependent insulinotropic peptide concentrations, which decreases postprandial rises in glucagon in both Type 1 and Type 2 diabetes. This study evaluates the clinical implications of sitagliptin in adult patients with Type 1 diabetes. Methods  This investigator-initiated, double-blind, randomized, crossover, 8-week, pilot study enrolled 20 adult subjects with Type 1 diabetes. Subjects received sitagliptin 100 mg/day or placebo for 4 weeks and then crossed over. Outcomes included 2-h postprandial blood glucose and 24-h area under the curve changes in glucose measurements from continuous glucose monitoring, HbA(1c) , fructosamine and insulin dose. Results  Sitagliptin significantly reduced blood glucose (2-h postprandial and 24-h area under the curve) despite reduced total and prandial insulin dose. Based on continuous glucose monitor findings, sitagliptin improved measures of glycaemic control, including mean blood glucose (-0.6 mmol/l; P = 0.012) and time in euglycaemic range 4.4-7.8 mmol/l (0.4 ± 0.2 h; P = 0.046). Significant reductions were also observed in M100, Glycemic Risk Assessment Diabetes Equation (GRADE) and J-index. After controlling for period, treatment and insulin dose, the HbA(1c) was also significantly reduced [-0.27 ± 0.11% (-2.91 ± 1.16 mmol/mol); P = 0.025] when patients were taking sitagliptin. Conclusions  Sitagliptin significantly improved overall glucose control, including postprandial and 24-h glucose control, in adult patients with Type 1 diabetes, while significantly reducing prandial insulin requirements. Further investigation is warranted in patients with Type 1 diabetes in a larger cohort designed to assess both clinical outcomes and mechanism of action.
Authors:
S L Ellis; E G Moser; J K Snell-Bergeon; A S Rodionova; R M Hazenfield; S K Garg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  28     ISSN:  1464-5491     ISO Abbreviation:  Diabet. Med.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1176-81     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
Affiliation:
Barbara Davis Center for Childhood Diabetes Department of Clinical Pharmacy, University of Colorado Denver Department of Internal Medicine and Pediatrics, University of Colorado Denver, Aurora, CO, USA.
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