The dipeptidyl peptidase-4 inhibitor may improve the insulin secretion in type 2 diabetes patients just after starting hemodialysis treatment: preliminary study

Abstract

Background: Dipeptidyl peptidase-4 inhibitors (DPP-4i) have become widely used in hemodialysis patients with type 2 diabetes mellitus (T2DM). This study aimed at testing the hypothesis that administration of alogliptin, a DPP-4i, soon after hemodialysis initiation improves beta cell function in hemodialysis patients with T2DM. Methods: Patients with end-stage renal disease and T2DM (n = 10) not previously treated with DPP-4i (mean age, 54.2 years) were enrolled. The study end point was the acute insulin response to glucose assessed by a frequently sampled intravenous glucose tolerance test (IVGTT) that was conducted during the hemodialysis session just before lunch using an external circulation circuit. All patients received 6.25 mg alogliptin for 2 weeks. Blood glucose (Glu), serum insulin (IRI), and C-peptide (CPR) were measured before (0 min) in addition to 5 and 15 min after the glucose load. Glucagon-like peptide-1 (GLP-1) was measured before the glucose load. Results: Glu(0) significantly decreased after the 2-week DPP-4i treatment (174 ± 20 vs. 150 ± 27 mg/dL, P = 0.023). IRI(5) significantly increased after the DPP-4i treatment (14.6 ± 31.7 vs. 23.4 ± 16.6 μU/mL, P = 0.038), but IRI(0) and IRI(15) did not change significantly. GLP-1 also significantly increased after the DPP-4i treatment (6.6 ± 4.4 vs. 2.6 ± 0. 8 pmol/L, P = 0.012). Conclusions: Inhibition of DPP-4 with alogliptin improved endogenous insulin secretion in response to intravenous glucose in hemodialysis patients with T2DM.

Two Novel Bioactive Peptides from Antarctic Krill with Dual Angiotensin Converting Enzyme and Dipeptidyl Peptidase IV Inhibitory Activities

“…DPP‐IV inhibitor peptides inhibit the normal rapid degradation of GIP and GLP‐1, through DPP‐IV. Insulin secreted by islet β‐cells is enhanced, and glucagon secretion is diminished, thereby lowering blood glucose concentration (Kawamoto and others ). Inhibition of DPP‐IV is recognized as an effective therapeutic method in type 2 diabetes.…”