Safety and Efficacy of DPP4 Inhibitor and Basal Insulin in Type 2 Diabetes: An Updated Review and Challenging Clinical Scenarios

Gómez-Peralta, Fernando; Abreu, Cristina; Gomez-Rodriguez, Sara; Barranco, Rafael J.; Umpiérrez, Guillermo E.

doi:10.1007/s13300-018-0488-z

Cited by 44 publications

(34 citation statements)

References 67 publications

(74 reference statements)

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“…Dipeptidyl peptidase-4 (DPP4) inhibitors are associated with low risk of hypoglycaemia and are relatively safe across a wide range of renal functions. DPP4 inhibitors added to basal insulin improve glycaemic control without increasing the risk of hypoglycaemia, even among hospitalised patients [55]. However, these agents are likely to be of less therapeutic benefit in patients with severe COVID-19.…”

Section: Management Of Patients With Diabetes and Covid-19mentioning

confidence: 99%

Prevention and management of COVID-19 among patients with diabetes: an appraisal of the literature

et al. 2020

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The coronavirus disease 2019 (COVID-19) pandemic has emerged as one of the greatest challenges faced by humankind in the recent past. People with diabetes and related comorbidities are at increased risk of its complications and of COVID-19-related death. Older age, multi-morbidity, hyperglycaemia, cardiac injury and severe inflammatory response are predictors of poor outcome. The complex interplay between COVID-19, diabetes and the effects of related therapies is being explored. Most patients experience a mild illness with COVID-19, while people with diabetes are at increased risk of severe disease. Optimising glycaemic control and adopting measures to prevent disease spread are critical aspects. The management of mild disease is supportive, while very many immunomodulatory and antiviral therapies are being investigated for the treatment of severe disease. Several of these agents have specific considerations for use in people with diabetes. Since mass population lockdowns are considered a key step in controlling disease spread, it follows that, in addition to the direct vulnerability to severe COVID-19, people with diabetes can be affected by limited access to healthcare, insulin, other medications and blood glucose monitoring equipment. Measures to prevent disease spread at the individual and community level are the key to mitigating the rapidly escalating pandemic, while agents for chemoprophylaxis and vaccines are being explored. People with diabetes should be recognised as a vulnerable group for complicated disease and are at risk during times of disturbed social systems. Strategies are needed to safeguard the health of patients with diabetes during the pandemic. This review summarises the current knowledge and perceived challenges for prevention and management of COVID-19 in people with diabetes.

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Section: Management Of Patients With Diabetes and Covid-19mentioning

confidence: 99%

Prevention and management of COVID-19 among patients with diabetes: an appraisal of the literature

et al. 2020

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“…In the IR cell model, the inhibited glucose uptake ability induced by PA treatment was markedly abrogated by the upregulation of miR-214. Interestingly, we found that the beneficial effects of miR-214 were similar to the treatment of VG, which is a widely used inhibitor of DPP4 in clinical practices [34]. More importantly, the combination treatment with miR-214 overexpression and VG resulted in a more significant improvement compared with the two alone in the IR animal and cell models, suggesting that the therapeutic efficacy of VG was promoted by the upregulation of miR-214.…”

Section: Discussionmentioning

confidence: 64%

Aberrant expression of miR-214 is associated with obesity-induced insulin resistance as a biomarker and therapeutic

Cheng

Yuan

et al. 2020

Diagn Pathol

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Background: Insulin resistance (IR) in obesity is associated with the occurrence of metabolic and cardiovascular diseases. Dipepidyl peptidase 4 (DPP4) plays a pivotal role during the development of IR, and was found to be a target gene of microRNA-214 (miR-214) in our study. This study sought to assess the expression and clinical value of miR-214 in obese patients with IR, and investigate its therapeutic potential in obese rats and adipocytes with IR. Methods: Serum expression of miR-214 in obese patients with or without IR was estimated by quantitative realtime-PCR. A receiver operating characteristic curve was plotted to evaluate the diagnostic value of miR-214 in the patients. Obesity-induced IR animal and cell models were constructed, and the therapeutic ability of miR-214 was explored. Results: Serum expression of miR-214 was decreased in obese patients compared with the healthy controls, and the lowest expression was observed in the cases with IR. Downregulation of miR-214 was significantly correlated with the serum DPP4 levels and HOMA-IR of the patients upon IR conditions, and was demonstrated to perform diagnostic accuracy for distinguishing obese patients with IR from those without IR. In obesity-associated IR animal and cell models, the downregulation of miR-214 was also been detected. According to the measurement of glucose and insulin tolerance and glucose uptake abilities, we found that the overexpression of miR-214 could be used to alleviate IR in the IR models, especially when collaboratively used with DPP4 inhibitor vildagliptin. Conclusion: All data revealed that miR-214, as a regulator of DPP4, is decreased in obese patients with IR and may serve as a diagnostic biomarker. The upregulation of miR-214 could improve IR in obese rats and adipocytes, indicating that miR-214 has the therapeutic potential for obesity and IR.

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“…Glucagon-like peptide-1 (GLP-1) analogues and dipeptidyl peptidase-4 (DPP4) inhibitors improve hyperglycemia through various mechanisms, including an enhancement of insulin release, a glucose-dependent decrease of postprandial glucagon as well as delayed gastric emptying. The use of DPP4 inhibitors alone or in combination with insulin is a safe and effective approach to control of blood glucose levels without elevating the risk of hypoglycemia or excessive weight gain [ 51 ]. DPP4 inhibitors show anti-inflammatory effects and do not potentiate ACE levels in animal models, consequently they may be considered useful in diabetic patients with COVID-19 [ 52 ].…”

Section: Control and Treatment Of Hyperglycemia In Covid-19 Patientsmentioning

confidence: 99%

Importance of hyperglycemia in COVID-19 intensive-care patients: Mechanism and treatment strategy

Mirzaei

Khodadadi

Vafaei

et al. 2021

Primary Care Diabetes

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Safety and Efficacy of DPP4 Inhibitor and Basal Insulin in Type 2 Diabetes: An Updated Review and Challenging Clinical Scenarios

Cited by 44 publications

References 67 publications

Prevention and management of COVID-19 among patients with diabetes: an appraisal of the literature

Prevention and management of COVID-19 among patients with diabetes: an appraisal of the literature

Aberrant expression of miR-214 is associated with obesity-induced insulin resistance as a biomarker and therapeutic

Importance of hyperglycemia in COVID-19 intensive-care patients: Mechanism and treatment strategy

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