Two DPP-4 Inhibitors Have Similar Effect on Incretin Secretion in Type 2 Diabetes

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Vildagliptin and sitagliptin similarly affect incretin hormone secretion.
Vildagliptin and sitagliptin similarly affect incretin hormone secretion.

(HealthDay News) — The dipeptidyl peptidase-4 (DPP-4) inhibitors vildagliptin and sitagliptin have similar effects on incretin hormone secretion, according to a study published in Diabetes, Obesity and Metabolism.

Oleg Baranov, from the Diabeteszentrum Bad Lauterberg in Germany, and colleagues compared the clinical effects of vildagliptin and sitagliptin in 24 patients with type 2 diabetes (12 diet/exercise, 12 on metformin). Participants were treated in randomized order for 7 to 9 days with vildagliptin, sitagliptin, or placebo.

The researchers found that with vildagliptin and sitagliptin, intact glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide concentrations were doubled. In most patients, meal-related total GLP-1 responses were reduced by vildagliptin and sitagliptin treatment (P=.0005 and .019, respectively), with considerable inter-individual variation. In those with greater increases in intact GLP-1 relative to total GLP-1 and who had greater reductions in fasting plasma glucose after DPP-4 inhibition, L-cell feedback was more pronounced. 

Overall, K-cell feedback inhibition was not significant. No between-group differences were seen in any clinical parameters.

"Vildagliptin and sitagliptin affected incretin hormones, glucose concentrations, insulin, and glucagon secretion in a similar manner," the researchers wrote. "Inter-individual variations in L-cell feedback inhibition may indicate heterogeneity in the clinical response to DPP-4 inhibition."

Disclosures: Several authors disclosed financial ties to pharmaceutical companies, including Novartis Pharma, which manufactures vildagliptin and funded the study.

Reference

  1. Baranov O, Kahle M, Deacon CF, Holst JJ, Nauck MA. Feed-Back Suppression of Meal-Induced GLP-1 Secretion Mediated through Elevations in Intact GLP-1 Caused by DPP-4 Inhibition: A Randomized, Prospective Comparison of Sitagliptin and Vildagliptin Treatment. Diabetes Obes Metab. 2016. doi:10.1111/dom.12706.
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