Sitagliptin improves albuminuria in patients with type 2 diabetes mellitus

Abstract

The aim of the present study was to determine the effect of sitagliptin on microalbuminuria in patients with type 2 diabetes mellitus. Materials and Methods: A total of 85 patients with type 2 diabetes mellitus (age >20 years, <80 years, hemoglobin A1c [HbA1c] <8.4%) were randomized to patients taking sitagliptin 50 mg or other oral glucose-lowering agents. The following parameters were evaluated at 0, 3 and 6 months after the treatment: bodyweight, blood pressure, HbA1c, fasting plasma glucose, fasting plasma insulin, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, estimated glomerular filtration rate and urinary albumin excretion. The primary outcome was changes in urinary albumin excretion at 6 months. Results: Significant and comparable falls in HbA1c and fasting plasma glucose were found in both groups. However, sitagliptin significantly reduced urinary albumin excretion within 6 months, especially in patients with high urinary albumin at baseline. A total of 27 patients with normoalbuminuria showed a reduction in urinary albumin excretion, suggesting that sitagliptin prevents the development of albuminuria. A total of 15 patients with albuminuria showed a reduction in urinary albumin excretion, suggesting the beneficial effect of sitagliptin in the early stage of diabetic nephropathy. There was a significant correlation between improvement of proteinuria and that of diastolic blood pressure. Conclusions:The results suggested that sitagliptin improved albuminuria, in addition to improving glucose. The mechanism of the reduction of albuminuria by sitagliptin could be a direct effect, as well as an increase in active glucagon-like peptide-1, independently affecting blood pressure, bodyweight and glucose metabolism. This trial was registered with the University Hospital Medical Information Network (UMIN no. #000010871).

Comparative analysis of the effects of alogliptin and vildagliptin on glucose metabolism in type 2 diabetes mellitus

“…Diabetic nephropathy might have progressed in Study 2 since patients of the switch-to-vildagliptin group with poor urinary albumin excretion had elevated blood pressure at 24 weeks. Other possible reasons for the difference in the results of Study 1 and Study 2 include a small sample size; short follow-up period; and the data used for Study 2 were those of switching from sitagliptin to vildagliptin, in which we have reported that sitagliptin was effective in reducing microalbuminuria [20]. Based on the above comparison, we think that our results indicate that urinary albumin excretion improved only in DPP-4 inhibitor-naive patients treated with vildagliptin at 100 mg daily.…”

The renoprotective effect and safety of a DPP-4 inhibitor, sitagliptin, at a small dose in type 2 diabetic patients with a renal dysfunction when changed from other DPP-4 inhibitors: REAL trial

“…In fact, human clinical studies reported that sitagliptin had reduced albuminuria in many T2DM patients with nephropathy [39][40][41][42]. When sitagliptin was administered, the bigger reduction of urinary albumin was observed in the cases who had the greater albuminuria at the baseline [40].…”

Drugs for Diabetic Nephropathy- Full Review

“…Such combination therapy should put in to trial in human subject, instead of sitagliptin linagliptin combined with CoQ10 Should be tried since study suggest linagliptin does not require dose adjustment and also restore the physiological balance of VEGF. [219,220] …”