Evaluation of Age-Specific Efficacy and Safety of 12 Months of Sitagliptin Therapy Administered by Non-Diabetologists

Abstract

Background:The mean age of overall incident dialysis patients is 68.9 years for men and 71.4 years for women, and it is increasing yearly, and diabetic nephropathy is the most common underlying disease of it. On the other hand, the number of diabetologist has been insufficient for an ever-increasing number of diabetic patients in Japan. In this context, the examination and treatment of diabetes in non-specialist settings, as well as in specialist settings, have become important.Methods: A multicenter, retrospective, observational study was conducted in Kanagawa, Japan. Laboratory data were compiled for 1 year at intervals of 3 months following the start of sitagliptin treatment. The subjects were divided into three groups by age: < 65 years (n = 148), 65 -74 years (n = 134), and ≥ 75 years (n = 127). Laboratory values in comparison with baseline were compared within groups at various time points, and changes from baseline were compared among the different groups. Participating doctors were not diabetologists. Results:In the 65 -74 and ≥ 75 years of age groups, estimated glomerular filtration rate (eGFR) was decreased significantly from baseline at months 3, 6, 9, and 12, whereas there was no significant decrease from the month-3 value at months 6, 9, or 12. Meanwhile, in the < 65 years of age group, eGFR was decreased significantly from baseline at months 9 and 12, whereas changes at months 3 and 6 were not significant. There were significant differences in the magnitude of eGFR changes among age groups at month 3, but not at months 6,9, or 12. Hemoglobin A1c (HbA1c) was reduced significantly at month 3, and the reduced level was maintained until month 12 in all age groups. Conclusions:The efficacy and safety of sitagliptin therapy in the elderly were confirmed in non-specialist settings. These findings will help non-diabetologists choose an appropriate drug in areas where the numbers of diabetic patients and elderly persons are increasing.