Endocrine Abstracts

DPP4 inhibitors are special class of drugs that not only improve metabolism in a glucose dependant manner, but also suppress the glucagon axis. Due to its glucose dependant insulinotropic action, vildagliptin is thought to be relatively safe for people who are at risk of developing low glucose episodes. We studied the glucose lowering potential and hypoglycemic effects of vildagliptin among elderly diabetics who were uncontrolled with at least 2 oral antidiabetic medications. For this study, we recruited elderly adults (aged more than 60 years) with type 2 diabetes and elevated HbA1c (> 8%). All the participants were on at least 2 OADs at the time of enrollment, but not on insulin or GLP-1 agonists within 3 months. After due consent they were administered vildagliptin 50 mg twice daily in addition to their existing therapy and were evaluated 6 months later. Data of 386 elderly adults (Males/Females: 275/111) were available for analysis. The mean age of the sample was 62.7 ± 10.8 years and the duration of diabetes was 10.6 ± 6.6 years respectively. At the time of enrollment into the study, their mean FPG and PPG were 149.5 ± 47.1 mg/dl and 221.0 ± 61.8 mg/dl respectively, which declined to 128.5 ± 235.4 mg/dl and 186.8 ± 50.5 mg/dl in order after 6 months’ treatment. During the same period, HbA1c was reduced in a statistically significant fashion. The change in HbA1c was 1.7 ± 1.6% from a baseline HbA1c of 9.8 ± 2.3%. Although overall incidences of hypoglycemia was not frequent, more number of cases occurred among individuals who were on sulfonylurea therapy (P < 0.05). There was no significant increase in the liver enzymes post treatment. The subjects did not experience any weight gain after the treatment. Our study showed that vildagliptin is a safe agent for the management of elderly diabetics and was found to reduce the glycemic parameters significantly. Addition of vildagliptin in elderly individuals improved the HbA1c by 1.7 ± 1.6% in 6months of treatment. Vildagliptin was also found to be weight neutral, which is important for the elderly population as they find it difficult to go for regular exercise due to the age related issues.