Endocrine Abstracts

Aim of the study: To examine the influence of sitagliptin in patients treated with a diabetic diet and metformin, on metabolic parameters and kidney function after three months of sitagliptin therapy.

Subjects and methods: 35 patients (19 men and 16 women) were included in the study. Sitagliptin was introduced in patients on a diabetic diet and metformin with HbA1c≥6.5%. Fasting and postprandial plasma glucose value, HbA1c, cholesterol, HDL, LDL, triglycerides, kidney function (endogenous creatinine clearance (ECC)), 24-hour proteinuria and albuminuria, urea, creatinine, urates, height, body mass, body mass index were observed.

Results: Fasting glucose decreased by 1.52 mmol/l (14.85%), and postprandial by 3.42 mmol/l (26.10%, P<0.001), HbA1c decreased by 1.05% (12.35%, P=0.001). Total cholesterol concentration decreased by 7% (P=0.07), HDL increased by 0.89% (P=0.31), LDL decreased by 12.39% (P=0.46) and triglycerides by 1.2% (P=0.74). Median ECC remained unchanged (P=0.59), initial mean proteinuria was 140 and final 149 mg/dU (P=0.4), while mean 24-hour albuminuria decreased by 3 mg/dU (P=0.07). Urea concentration increased from initial 5.3 (SD 1.42) to 5.52 µmol/l (SD 1.31, P=0.37), creatinine concentration increased by 3.23% (P=0.02), which was statistically significant, and the concentration of urate was reduced by 0.43% (P=0.66). Furthermore, BMI was reduced by 2.3% (P=0.18).

Conclusion: After administration of sitagliptin, fasting and postprandial glucose concentrations were significantly reduced, as well as HbA1c. Changes in the concentration of cholesterol, HDL, LDL and triglycerides and body weight were not statistically significant. The change in the concentration of urea, urate, ECC, proteinuria and albuminuria were not significant, while the slight increase in creatinine was statistically significant. The above indicates that sitagliptin is a metabolically neutral drug with a milder negative effect on renal function.

Key words: Sitagliptin, Metformin, Diabetic nephropathy, Lipid metabolism