Chitosan oligosaccharide improves the therapeutic efficacy of sitagliptin for the therapy of Chinese elderly patients with type 2 diabetes mellitus

Abstract

Sitagliptin improves glycemic control in type 2 diabetes mellitus (T2DM) patients but its side effects are undesirable. Chitosan oligosaccharide (COS) is expected to improve the therapeutic result as a natural product. A total of 200 elderly T2DM patients were evenly assigned into four groups: sitagliptin group (SG), receiving sitagliptin 100 mg/day; COS group (CG), receiving COS 100 mg/day; combination therapy of sitagliptin and COS group (SCG), receiving both sitagliptin and COS 100 mg/day; and placebo group (PG), receiving placebo 100 mg/day. After 42-week therapy, biochemical indices and clinical parameters for the alterations from start points were analyzed. The related molecular mechanism was tested by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot at cell level. Lower risk of hypoglycemia was found in the SCG group when compared with SG and other groups (P<0.05). More patients from the SCG group than other groups attained hemoglobin A1c (HbA1c) reduction >2.5% (P<0.05). Weight reduction of 1.2±0.9, 2.6±0.8, 4.7±1.3, and 0.9±0.6 kg was observed in the patients from SG, CG, SCG, and PG groups, respectively (P<0.05). The combined treatment of COS and sitagliptin presented better therapeutic results by improving insulin sensitivity, lipid profile, adiponectin levels, and glucagon-like peptide 1 and reducing side effects, insulin resistance, HbA1c, body mass index, resistin, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) (P<0.05). qRT-PCR and Western blot analysis also showed that COS treatment reduced the levels of resistin, TNF-α, and CRP, and increased the level of adiponectin. The combination of COS and sitagliptin provided better glycemic control with fewer side effects and with more weight reduction in the elderly participants with T2DM.

Tamarind Trypsin Inhibitor in Chitosan–Whey Protein Nanoparticles Reduces Fasting Blood Glucose Levels without Compromising Insulinemia: A Preclinical Study

“…Regarding the reduction of fasting glucose concentrations in the CW group (Figure 3A), this canprobably be attributed to chitosan, which exhibits hypoglycemic activity, as observed in previous studies [38,39,40,41]. Additionally, CW also significantly reduced insulin, HOMA IR, and HOMA- β .…”

Apelin‑13 ameliorates metabolic and cardiovascular disorders in a rat model of type 2 diabetes with a high‑fat diet

“…Diabetes is an inflammatory disease in which the levels of pro-inflammatory cytokines, including TNF-α, are elevated in the serum of patients (35,36). A previous study indicated that high levels of TNF-α is a crucial risk factor for diabetes (37). Furthermore, TNF-α is an important indicator of insulin resistance in obesity and may serve as a target for improving obesity-induced insulin resistance in patients with type 2 diabetes (38).…”

A Retrospective Cohort Study of Patients with Type 2 Diabetes in China: Associations of Hypoglycemia with Health Care Resource Utilization and Associated Costs

“…Efforts have been made to reduce the healthcare costs associated with hypoglycemia and to increase knowledge of hypoglycemia in patients and their families [ 36 ]. In addition to alleviating the hypoglycemia itself, hypoglycemic patients should be shifted to a more appropriate insulin therapy option in order to reduce side effects, improve the outcome, and to initially mitigate the burden on the patient [ 6 , 37 – 41 ].…”