Diabetes Metab J.  2015 Aug;39(4):342-347. 10.4093/dmj.2015.39.4.342.

Predictive Factors for Efficacy of Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes Mellitus

Affiliations
  • 1Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan. syagi@tokushima-u.ac.jp
  • 2Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
  • 3Department of Medical Education, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
  • 4Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.

Abstract

BACKGROUND
Predictive factors for the efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors for lowering glycosylated hemoglobin (HbA1c) remain unclear in patients with type 2 diabetes mellitus. The aim of this study is therefore to clarify predictive factors of the efficacy of DPP-4 inhibitors for lowering HbA1c after 12 months of treatment.
METHODS
A total of 191 consecutive type 2 diabetic patients (male sex 55%, mean age, 68.3+/-35.8 years), who had been treated with DPP-4 inhibitors for 12 months, were enrolled in this study and evaluated retrospectively.
RESULTS
After 12 months of DPP-4 inhibitor treatment, random blood glucose level, and HbA1c level, decreased from 167+/-63 to 151+/-49 mg/dL (P<0.01), and from 7.5%+/-1.3% to 6.9%+/-0.9% (P<0.01) respectively, without severe side effects. Multiple regression analysis showed that predictors of DPP-4 inhibitor treatment efficacy in lowering HbA1c level after 12 months were a decrease in HbA1c level after 3 months of treatment, a high baseline HbA1c level, a low baseline body mass index, and the absence of coronary artery disease.
CONCLUSION
Most suitable candidates for treatment with DPP-4 inhibitors are diabetics who are not obese and do not have coronary artery disease. In addition, long-term efficacy of DPP-4 inhibitors can be predicted by decrement of HbA1c after 3 months of treatment.

Keyword

Coronary artery disease; Diabetes mellitus; Dipeptidyl-peptidase IV inhibitors; Obese; Predictive factors

MeSH Terms

Blood Glucose
Body Mass Index
Coronary Artery Disease
Diabetes Mellitus
Diabetes Mellitus, Type 2*
Dipeptidyl-Peptidase IV Inhibitors
Hemoglobin A, Glycosylated
Humans
Retrospective Studies
Treatment Outcome
Blood Glucose
Dipeptidyl-Peptidase IV Inhibitors
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