Endocrine Abstracts

Objective: Analyze the use of DPP-4 inhibitors (iDPP4) in a specialized consultation as well as metabolic impact, weight and safety in patients with diabetes mellitus type 2 (DM2).

Material and methods: We analyzed 100 patients with DM2, derivative to Diabetes hospital with debut or poor glycemic control. We initiated them sitagliptin 100 mg/day and reinforced Diabetes education. We studied the HbA1c, weight and severe hypoglycemia. Statistical analysis was performed with SPSSv18, making a t-student and Wilconson test.

Results: Forty-six percent of our patients were referred in debut and the remaining 64% with DM2 poorly controlled. They had a mean age of 57.6±12.7 years and a mean of 4.8±6.4 years of DM2 evolution and had a mean BMI of 30.5±4.9 kg/m². We appreciated a total decrease of mean HbA1c of 9.2 to 6.6% (−2.7*%) and a total mean weight loss of −1.57* kg. In none of the patients observed severe hypoglycemia. Besides the subgroup analyzed by combined use with sitagliptin.

– Monotherapy (n=3): decrease mean HbA1c from 7.3 to 6.1% (−1.2%*), and average weight loss of −2.80 kg*.

– Dual therapy (n=55): decrease mean HbA1c from 9.4 to 6.4% (−3.0%*), and average weight loss of −2.97 kg*.

– Triple therapy (n=7): decrease mean HbA1c from 8.1 to 6.9% (−1.2%*), and average weight loss of −3.09 kg*.

– Insulin basal therapy (n=35): decrease mean HbA1c from 9.4 to 6.6% (−2.8%*), and average weight loss of −0.75 kg*.

*P<0.05

Conclusions: The most frequent use of iDPP4 was performed in combination therapy with metformin, followed by association with basal insulin plus metformin. Therapy with DPP-4 is effective treatment option in the first step (in intolerant to metformin), as 2nd oral drug, in triple therapy, even with basal insulin. The profile beneficial weight and hypoglycemia security makes it ideal for the treatment of overweight patients with DM2.