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Open Access 01-10-2017 | Original Research

Dose-Dependent Effect of Sitagliptin on Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus Receiving Insulin Treatment: A Post Hoc Analysis

Authors: Tomoya Mita, Naoto Katakami, Toshihiko Shiraiwa, Hidenori Yoshii, Masahiko Gosho, Iichiro Shimomura, Hirotaka Watada

Published in: Diabetes Therapy | Issue 5/2017

Abstract

Introduction

Dipeptidyl peptidase-4 (DPP-4) inhibitors reduce blood glucose in a dose-dependent manner, but the dose-dependent effect relationship between DPP-4 inhibitors and atherosclerosis has not been investigated.

Methods

Patients with type 2 diabetes mellitus (T2DM) treated with insulin were randomized to the sitagliptin (n = 137) or conventional treatment group (n = 137). In the sitagliptin group, each investigator was allowed to adjust the sitagliptin dose to avoid hypoglycemia. In this post hoc analysis, subjects in the sitagliptin group were divided into two groups based on the average dose of sitagliptin during the study period: greater than or equal to median (higher sitagliptin dose group) or less than median (lower sitagliptin dose group).

Results

In this study, subjects were divided into three groups: the conventional treatment group (n = 137), lower sitagliptin dose group (n = 42), and higher sitagliptin dose group (n = 95). The higher sitagliptin dose group had a significantly larger reduction in HbA1c (−0.62 ± 1.05%) than the conventional treatment group (−0.20 ± 0.91%, P = 0.007). Over 104 weeks, the higher sitagliptin dose significantly reduced the mean intima media thickness-common carotid artery (IMT-CCA) and left max-IMT-CCA relative to baseline. In addition, the higher sitagliptin dose significantly inhibited the progression in mean-IMT-CCA compared with conventional treatment. Multiple linear regression analysis showed that changes in mean-IMT-CCA and left max-IMT-CCA decreased with higher sitagliptin dose.

Conclusions

Addition of sitagliptin to insulin therapy might attenuate the progression of atherosclerosis in patients with T2DM in a dose-dependent manner.

Funding

Mitsubishi Tanabe Pharma Co., Ono Pharmaceutical Co., and Novo Nordisk.

Clinical trial registration

UMIN000007396

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Title: Dose-Dependent Effect of Sitagliptin on Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus Receiving Insulin Treatment: A Post Hoc Analysis
Authors: Tomoya Mita
Naoto Katakami
Toshihiko Shiraiwa
Hidenori Yoshii
Masahiko Gosho
Iichiro Shimomura
Hirotaka Watada
Publication date: 01-10-2017
Publisher: Springer Healthcare
Published in: Diabetes Therapy / Issue 5/2017
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI: https://doi.org/10.1007/s13300-017-0309-9

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Dose-Dependent Effect of Sitagliptin on Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus Receiving Insulin Treatment: A Post Hoc Analysis

Abstract

Introduction

Methods

Results

Conclusions

Funding

Clinical trial registration

ACC 2024 Congress Coverage

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Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Funding

Clinical trial registration

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