BackgroundTeneligliptin is a novel, highly selective dipeptidyl peptidase-4 (DPP-4) inhibitor. The aim of this study is to explore the glycemic and non-glycemic efficacies of teneligliptin as an initial therapy.MethodsNewly diagnosed, drug naive Japanese subjects with type 2 diabetes (T2DM) were assigned to 20 mg/day teneligliptin monotherapy (n = 31). At 3 months, levels of glycemic and other parameters were compared with those at baseline.ResultsSignificant reductions of HbA1c (from 10.34 ± 2.06 to 8.38 ± 2.23%) and fasting blood glucose (FGB, from 211.3 ± 68.4 to 167.3 ± 70.2 mg/dL) levels were observed without any clinically significant adverse events. However, significant increases of uric acids (UA) levels were observed and two subjects reported mild hypoglycemic events. Homeostasis model assessment-B (HOMA-B) levels significantly increased, while high HOMA-R levels significantly decreased. Significant correlations were observed between the changes (Δ) of HbA1c and those of HOMA-B, and between ΔFBG and ΔHOMA-R. No changes in lipid and body weight were noted.ConclusionsTeneligliptin might be effectively and safely used as an initial therapy for newly diagnosed T2DM. Glycemic efficacy of teneligliptin is obtained through activating beta-cell function as well as decreasing insulin resistance.

It is known that linagliptin, a novel DPP-4 inhibitor, can be used in patients even with severe renal impairment. So far, there have been no reports describing the clinical presentations and features of a patient with linagliptin-induced renal toxicity. A 66-year-old Japanese man had developed nausea and elevations of creatinine and potassium levels at 4 weeks after switching from sitagliptin to linagliptin. No emesis or diarrhea was noted. These renal parameters had slowly recovered after switching-back to sitagliptin. This slow recovery process may be due to the very long half-life of this drug. Although no single case report can prove case or effect of drugs, it is still safe that physicians carefully monitor renal function upon administration of linagliptin, especially in those with certain degrees of chronic kidney disease.