DPP4-i Plus α-Glucosidase Inhibitor Reduces HbA1c in T2D

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Both placebo and DPP4-i had similar risks of hypoglycemia and adverse gastrointestinal events.
Both placebo and DPP4-i had similar risks of hypoglycemia and adverse gastrointestinal events.

HealthDay News — For patients with type 2 diabetes (T2D), inadequately controlled with alpha-glucosidase inhibitors (AGIs), the addition of a dipeptidyl peptidase-4 (DPP4) inhibitor (DPP4i) is associated with a greater reduction in HbA1c, according to a review published online in the Journal of Diabetes Investigation.

Se Hee Min, MD, from the Seoul National University College of Medicine in South Korea, and colleagues conducted a literature review to examine the efficacy and safety of the addition of a DPP4i to patients with T2D inadequately controlled with an AGI. Data were included from five studies with 845 patients randomized to DPP4i/AGI and 832 randomized to placebo plus AGI (PCB/AGI).

The researchers found that DPP4i/AGI correlated with a greater reduction in HbA1c than PCB/AGI (weighted mean difference, -1.2%), fasting plasma glucose, and 2-hour postprandial plasma glucose levels; no increase was seen in body weight. DPP4i/AGI and PCB/AGI had similar risks of hypoglycemia and gastrointestinal adverse events.

"Addition of a DPP4 inhibitor to patients with T2D inadequately controlled with an AGI achieved better glycemic control without further increasing the risk of weight gain and hypoglycemia," the authors write.

Disclosure: One author disclosed financial ties to AstraZeneca and LG Chemical.

Reference

Min SE, Yoon J-H, Hahn S, Cho YM. Efficacy and safety of combination therapy with an α-glucosidase inhibitor and a dipeptidyl peptidase-4 inhibitor in patients with type 2 diabetes mellitus: A systematic review and meta-analysis [published online October 25, 2017]. J Diabetes Invest. doi:10.1111/jdi.12754

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