Endocrine Abstracts

Introduction: DDP4i improves the function of β-cells and α-cells. However, there have been short-term follow-up and young subjects in many experimental and clinical studies. The imbalance of pancreatic endocrinocytes increases in adulthood and changes become less reversible. We decided that it would be useful to study the morphofunctional features of pancreatic endocrinocytes while taking iDPP4 in the older age group in the clinic and experimentally.

Materials and methods: Male Wistar rats with streptozotocin-nicotinamide-induced type 2 diabetes (DM type 2) (n =20, age over 12 months) received group therapy for 24 weeks.1. Control - healthy control group.2. DM type 2 - DM type 2 without therapy.3. DPP4i - Vildagliptin 1.5 mg per kg.Pancreatic preparations were made after the end of therapy. Immunohistochemical study was carried out with antibodies to glucagon, insulin.Patients (n =36, over 50 years of age) were divided into groups depending on the therapy.1. DPP4i for more than a year in combination with Metformin.2. Metformin + sulfonylurea preparation(SU).Insulin, glucagon, C-peptide levels were examined before and after a standard breakfast. The HOMA IR and HOMA β indices were calculated.

Results: Experiment. A statistically significant difference in the volume of β-cells (significantly less in the group DM type 2(P <0.05)), in the volume of α-cells (significantly more in the group DM type 2 (P <0.05)) was revealed when comparing DM type 2 group with a healthy control group. A statistically significant difference(P <0.05) was obtained when comparing the DM type 2 group without therapy and the DPP4i group. The number of β-cells was significantly higher with iDPP4 therapy, and the number of α-cells was significantly lower. There was no statistically significant difference in the number of β- and α-cells (P > 0.05) when comparing the DDP4i group with the control group. Clinical part of the study. We obtained a significant difference in fasting glucagon and insulin levels between the Metformin + DPP4i and Metformin + SU groups (P <0.05). More significant hyperglucagonemia and hyperinsulinemia were observed in the group receiving Metformin + SU.Discussion.Long-term use of drugs DPP4i contributed to the normalization of the number of β- and α-cells in the experiment. And also DPP4i reduced the secretory imbalance of insulin and glucagon in a clinical study. Our results show that DPP4i contributes to the normalization of the functional state of pancreatic endocrinocytes, including in older age groups.