| Effect of sitagliptin on glucose control in adult patients with Type 1 diabetes: a pilot, double-blind, randomized, crossover trial. | |
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MedLine Citation:
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PMID: 21923696 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2011-09-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8500858 Medline TA: Diabet Med Country: England |
Other Details:
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Languages: eng Pagination: 1176-81 Citation Subset: IM |
Copyright Information:
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© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK. |
Affiliation:
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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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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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