Sitagliptin added to previously taken antidiabetic agents on insulin resistance and lipid profile: a 2‐year study evaluation

Abstract

The aim of this study was to evaluate whether the positive effects of sitagliptin on glycemic control and insulin resistance were maintained also after 2 years of therapy and whether sitagliptin could be effective also in improving lipid profile. In this randomized, double-blind, placebo-controlled trial, 205 patients with type 2 diabetes in therapy with different antidiabetic drugs were randomized to add sitagliptin 100 mg once a day or placebo to their current therapy. We evaluated at the baseline and after 6, 12, 18, and 24 months the following parameters: body mass index, glycated hemoglobin (HbA1c ), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (Tg). Sitagliptin, added to previously taken antidiabetic agents, proved to be effective in improving glycemic profile, reducing HbA1c by -17.5%, FPG by -12.7%, PPG by -20.5%. Regarding insulin resistance, sitagliptin decreased FPI by -8.3% and HOMA-IR by -20.0%, confirming that what have been already reported in short-term studies can be applied also after 2 years of treatment. Sitagliptin also reduced body weight by -4.3%. Our study also showed the positive effect of sitagliptin on lipid profile; in particular, sitagliptin decreased TC by -13.3%, LDL-C by -20.4%, and Tg by -32.3%, and also increased HDL-C by + 13.6%. Sitagliptin proved to be effective on glycemic profile and insulin resistance even after 2 years of therapy and to be effective in improving body weight and lipid profile.

Effect of Sitagliptin on glycemic profiles and their correlation with PASI score in patients with plaque psoriasis

“…Gyldenløve M1. et al [28] and Derosa G. et al [29] demonstrated that patients with psoriasis are more insulin resistant compared with healthy control subjects and they showed that sitagliptin is effective in improving the sign of hyperglycemia together with a reduction of insulin resistance. Antiinflammatory effect of sitagliptin on cytokines and natural killer cells in psoriatic lesion might lead to diminution in insulin resistance and hyperglycemia which could be a contributing factor of epidermal cells dysfunction and formation of psoriatic plaques [30].…”

Teneligliptin, a Chemotype Prolyl-Thiazolidine-Based Novel Dipeptidyl Peptidase-4 Inhibitor with Insulin Sensitizing Properties

“…FBG fasting blood glucose, HOMA-R homeostasis model assessment-R, HOMA-B homeostasis model assessment-B, BMI body mass index, non-HDL-C non-high density lipoprotein cholesterol [20,21], while others reported no such effects [22,23] with sitagliptin. The following reasons can be postulated to explain this discrepancy.…”

Cardiovascular Effects of Dipeptidyl Peptidase-4 Inhibitors: From Risk Factors to Clinical Outcomes

“…In patients initiating sitagliptin, change in body weight was significantly associated with improvements in fasting triglycerides and total cholesterol 60 . When added to previously taken antidiabetic agents, sitagliptin after 2 years of therapy reduced body weight and insulin resistance and improved lipid profile (reduction in total and LDL cholesterol, lowering of triglycerides and augmentation in HDL cholesterol) 80 . A meta-analysis suggested a possible beneficial effect of DPP-4 inhibitors on cholesterol, which, although small, could contribute to the reduction of CV risk 81 .…”