The Beneficial Effects of the DPP-4 Inhibitor Alogliptin on Hemoglobin A1c and Serum Lipids in Japanese Patients with Type 2 Diabetes

Abstract

It has been reported that dipeptidyl peptidase-4 (DPP-4) inhibitors improve hemoglobin A1c (HbA1c) levels in diabetic patients and may also improve the serum lipids. However, few studies have examined relationship between the effects of the DPP-4 inhibitor and the pretreatment HbA1c levels in diabetic patients. Furthermore, it has been reported that prolonged treatment with DPP-4 inhibitors may make glycemic control difficult in some patients. In the present study, we investigated (1) the effect of the DPP-4 inhibitor alogliptin on HbA1c, blood glucose (BG), and serum lipid in Japanese patients with type 2 diabetes, (2) the relationship between the HbA1c levels at baseline and the effects of alogliptin, and (3) the effects of switching of the DPP-4 inhibitor to alogliptin after 12 months' administration of sitagliptin on glycemic control and serum lipids. After 6-months' treatment with alogliptin, we found reductions of HbA1c, BG, and serum total cholesterol, and LDL cholesterol levels. Pretreatment level of HbA1c was well correlated with the degree of reduction of both HbA1c and BG levels after the treatment. Also, alogliptin kept levels of HbA1c and BG reduced by sitagliptin for 12 months, and relapsing of these levels and serum lipids were not observed. This study revealed that alogliptin improved HbA1c, BG, and serum lipid profiles in type 2 diabetic patients, and the effect of alogliptin on HbA1c and BG levels was correlated with HbA1c level at pretreatment. Furthermore, long-term treatment with alogliptin did not cause relapsing of glycemic control and serum lipids.

A 52‐week extension study of switching from gemigliptin vs sitagliptin to gemigliptin only as add‐on therapy for patients with type 2 diabetes who are inadequately controlled with metformin alone

“…More than 80% of AEs reported in each group were mild. A total of 26 serious adverse events (SAEs) occurred in 24 patients (7,8 and 9 patients in the S/G2, G1/G2 and G2/G2 groups, respectively).…”

“…Although this study revealed that the HbA1c-lowering effect of alogliptin was not attenuated after switching from sitagliptin, the number of patients (6) was very small. 8 In another retrospective cohort study, the subjects were 92 patients with T2DM whose prescription for sitagliptin 50 mg qd was switched to vildagliptin 50 mg bid. The per protocol analysis showed that switching to vildagliptin 50 mg bid significantly lowered HbA1c levels.…”

Effects of sitagliptin on blood glucose, lipids, pancreatic β cell secretory function and insulin resistance in patients with type 2 diabetes mellitus

“…Although the hypoglycemic effect of sitagliptin is widely recognized, its hypolipidemic effect has not been thoroughly studied. Previous studies have shown that sitagliptin, as an inhibitor of DPP-4 does not directly participate in the metabolism of blood lipids, but it can indirectly reduce blood lipids by acting on sympathetic reflex and enhancing postprandial lipid mobilization and degradation [12]. Some studies have also suggested that sitagliptin increases blood level of GLP-1 which acts on the hypothalamus, and decreases appetite, calorie and fat ingestion by reducing gastric emptying time and increasing satiety [13].…”

Effect of alogliptin on hypertensive chronic kidney disease patients with type 2 diabetes mellitus

“…This is in line with other studies that have shown better glycaemic control when adding DPP-4i therapy to metformin, insulin or sulfonylureas. 27 In the present study the level of 1,5-AG was measured as a short term marker for glycemic control since it has been found to be a more sensitive tool to check day to day glycemic control. 28 The 1,5-AG values and postprandial glucose levels showed an overall decrease and this tendency toward improvement suggested the possibility that alogliptin might improve postprandial hyperglycaemia.…”