Marked improvement of elderly postprandial hypotension by dipeptidyl peptidase IV inhibitor

Yonenaga, Akihiko; Ota, Hidetaka; Honda, Masayuki; Koshiyama, Daisuke; Yagi, Takashi; Hanaoka, Yoko; Yamamoto, Hiroshi; Yamaguchi, Yasuhiro; Iijima, Katsuya; Akishita, Masahiro; Ouchi, Yasuyoshi

doi:10.1111/j.1447-0594.2012.00903.x

Cited by 9 publications

(12 citation statements)

References 6 publications

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“…This study was also stimulated by the recognition that postprandial hypotension lacks an effective management approach, occurs frequently in T2DM, and that exogenous GLP‐1 markedly attenuates the postprandial fall in BP, induced by oral and intraduodenal glucose, in healthy older participants and patients with T2DM. Furthermore, two recent case reports were supportive of the efficacy of DPP‐4 inhibition in patients with postprandial hypotension . Clinical studies are indicative of a neutral effect of DPP‐4 inhibition on BP, but have not focused specifically on the postprandial state.…”

Section: Discussionmentioning

confidence: 99%

“…Large‐scale clinical trials relating to the effects of DPP‐4 inhibition on BP have not discriminated between fasting and postprandial effects and report little, if any, overall effect. That DPP‐4 inhibition may be beneficial in the management of postprandial hypotension is supported by two recent, uncontrolled, case reports …”

Section: Introductionmentioning

confidence: 85%

“…That DPP-4 inhibition may be beneficial in the management of postprandial hypotension is supported by two recent, uncontrolled, case reports. 25,26 The present study was designed to determine the acute effects of sitagliptin on GE, postprandial glycaemia and BP in T2DM.…”

mentioning

confidence: 99%

“…glucose, in healthy older participants and patients with T2DM. Furthermore, two recent case reports were supportive of the efficacy of DPP-4 inhibition in patients with postprandial hypotension 25,26. Clinical studies are indicative of a neutral effect of DPP-4 inhibition on BP, but have not focused specifically on the postprandial state.…”

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confidence: 99%

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Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes

Stevens

Buttfield

et al. 2019

Diabetes Obesity Metabolism

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Aims To determine the effects of the dipeptidyl peptidase‐4 inhibitor, sitagliptin, on gastric emptying (GE) of a high‐carbohydrate meal and associated glycaemic and blood pressure (BP) responses in type 2 diabetes mellitus (T2DM). Materials and Methods Fourteen patients with T2DM (nine men, five women; age 67.8 ± 1.5 years; body mass index 31.2 ± 0.9 kg/m2; T2DM duration: 4.2 ± 0.9 years; glycated haemoglobin: 46 ± 1.8 mmol/mol [6.4% ± 0.2%]), managed by diet and/or metformin, underwent concurrent measurements of GE, BP and plasma glucose for 240 minutes after ingestion of a radiolabelled mashed potato meal after receiving sitagliptin (100 mg) or placebo in randomized, double‐blind, crossover fashion on 2 consecutive days. Results Sitagliptin reduced postprandial plasma glucose (P < .005) without affecting GE (P = .88). The magnitude of the glucose‐lowering effect (change in incremental area under the curve0–240 min from placebo to sitagliptin) was related to GE (kcal/min) on placebo (r = 0.68, P = .008) There was a comparable fall in systolic BP (P = .80) following the meal, with no difference between the 2 days. Conclusions In T2DM, while sitagliptin has no effect on either GE or postprandial BP, its ability to lower postprandial glucose are dependent on the basal rate of GE.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 85%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes

Stevens

Buttfield

et al. 2019

Diabetes Obesity Metabolism

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“…In patients with autonomic nervous system dysfunction, delayed systemic blood pressure responses to increased mesenteric arterial flow can cause postprandial hypotension, and α-glucosidase inhibitors such as acarbose have been reported to improve postprandial hypotension [1]. In a recent case report, it was reported that dipeptidyl peptidase-4 (DPP-4) inhibitors can also ameliorate postprandial hypotension [2]. However, there have not been any reports about the relationship between postprandial glucose levels before and after the administration of DPP-4 inhibitors in patients with autonomic nervous system dysfunction due to dementia with Lewy bodies.…”

Section: Introductionmentioning

confidence: 99%

Postprandial and Orthostatic Hypotension Treated by Sitagliptin in a Patient with Dementia with Lewy Bodies

2016

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Patient: Female, 78Final Diagnosis: Dementia with Lewy bodySymptoms: Dizziness • sycopeMedication: —Clinical Procedure: —Specialty: GeriatricsObjective:Unusual setting of medical careBackground:Postprandial hypotension, induced by an absorption of glucose from intestine, could be treated by acarbose; however, it was unclear whether dipeptidyl peptidase-4 inhibitor reduced postprandial hypotension.Case Report:A 78-year-old woman who had experienced episodes of dizziness and hypotension after eating was admitted to our hospital. During 24-hour ambulatory blood pressure monitoring, there were repeated episodes of marked postprandial hypotension; i.e., a significant systolic blood pressure reduction within two hours after eating (from ‒58 to ‒64 mm Hg after meals). The patient was diagnosed with dementia with Lewy bodies. The patient exhibited postprandial hyperglycemia and hypotension after a 75 g oral glucose tolerance test. After the administration of 25 mg sitagliptin, the patient’s postprandial and orthostatic hypotension was reduced remarkably. Moreover, her Mini-Mental State Examination score subsequently increased (from 22 to 25 points).Conclusions:The dipeptidyl peptidase-4 inhibitor sitagliptin can delay postprandial increases in glucose levels and hypotensive episodes, as well as sympathetic nervous system abnormalities and orthostatic hypotension.

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Postprandial Hypotension

Alagiakrishnan

Mah

2019

Hypotensive Syndromes in Geriatric Patients

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Marked improvement of elderly postprandial hypotension by dipeptidyl peptidase IV inhibitor

Cited by 9 publications

References 6 publications

Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes

Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes

Postprandial and Orthostatic Hypotension Treated by Sitagliptin in a Patient with Dementia with Lewy Bodies

Postprandial Hypotension

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