DPP-4 INHIBITOR THERAPY IN PATIENTS AFTER PANCREATIC TRANSPLANT.

Abstract

OBJECTIVE:

Management of new onset hyperglycemia after pancreas transplantation (PT) is not well studied. There is a lack of information on effective and safe management options for hyperglycemia after PT. We tested the hypothesis that early intervention for hyperglycemia using a dipeptidyl peptidase-4 (DPP-4) inhibitor prolongs insulin-free graft function in patients after PT.

METHODS:

Twenty-six patients who developed noninsulin-dependent hyperglycemia at least 1 year after PT met the inclusion criteria for this retrospective chart review. Sitagliptin, a DPP-4 inhibitor, was a commonly used therapy for hyperglycemia after PT due to its wide availability and coverage. The standard therapy group included patients who did not receive any oral or noninsulin injection therapy until insulin was clearly required to control hyperglycemia. The intervention group included patients who had received sitagliptin soon after hyperglycemia developed. The median follow-up period was 45 months. The time to hyperglycemia from 1 year after PT and time to insulin requirement after hyperglycemia development were compared between these 2 groups.

RESULTS:

The time to hyperglycemia after PT was not different between the groups, but the time to insulin requirement was significantly longer in the intervention group compared with the standard therapy group (P<.001). After adjusting for body mass index (BMI), the difference remained significant (P<.001).

CONCLUSION:

Early treatment of hyperglycemia after PT with a DPP-4 inhibitor such as sitagliptin prolongs the time to insulin therapy compared with a standard observation approach. Prospective studies are needed to further investigate this observation.

• Authors: Ahmet B Ergin, Emilio Poggio, Venkatesh Krishnamurthi, Tania Jaber, Betul A Hatipoglu
• Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (Endocr Pract) Vol. 21 Issue 6 Pg. 567-73 (Jun 2015) ISSN: 1530-891X [Print] United States
• PMID: 25667364 (Publication Type: Journal Article)

Chemical References

• Dipeptidyl-Peptidase IV Inhibitors
• Hypoglycemic Agents
• Sitagliptin Phosphate

Topics

• Adult
• Dipeptidyl-Peptidase IV Inhibitors (therapeutic use)
• Female
• Humans
• Hyperglycemia (drug therapy)
• Hypoglycemic Agents (therapeutic use)
• Male
• Middle Aged
• Pancreas Transplantation
• Retrospective Studies
• Sitagliptin Phosphate (therapeutic use)