Although SGLT-2i, DPP-4i, and GLP-1 RAs are recommended as 2nd or 3rd line therapy for type 2 diabetes, important differences exist in the characteristics of users of these drugs. Contrary to existing guidelines, new users of DPP-4i had a higher prevalence of cardiovascular disease at baseline than new users of SGLT2i or GLP-1RA (BMC Endocrine Disorders)
Diabetes News
Tag: DPP4 inhibitors
Effectiveness and safety of new oral and injectable agents for in-hospital management of type 2 diabetes in general wards: systematic review and meta-analysis
Our review suggests that inpatient management in the general ward with DPP4i and GLP1Ra is as effective and safe as management with insulin. More randomized studies are required to support these findings before they could be recommended as usual practice (Diabetes Research and Clinical Practice)
Dipeptidyl peptidase-4 inhibitors and gallbladder or biliary disease in type 2 diabetes: systematic review and pairwise and network meta-analysis of randomised controlled trials
Dipeptidyl peptidase-4 inhibitors increased the risk of cholecystitis in randomised controlled trials, especially with a longer treatment duration, which requires more attention from physicians in clinical practice (BMJ)
Effect of Dipeptidyl Peptidase-4 (DPP-4) Inhibition on Biomarkers of Kidney Injury and Vascular Calcification in Diabetic Kidney Disease: A Randomized Controlled Trial
Our study showed that gemigliptin significantly improved the expression of renal tubular injury biomarkers and vascular calcification levels among patients with DKD; however, gemigliptin did not affect renal function or coronary calcification compared with those observed in the control (Journal of Diabetes Research)
Dipeptidyl peptidase-4 inhibitor and insulin combination treatment in type 2 diabetes and chronic kidney disease: a meta-analysis
This study demonstrated the effectiveness and safety of DPP-4 inhibitors bonded with insulin in patients with T2D and CKD, but the protective actions of this cure on kidney and cardiovascular outcomes, as well as the functions of other DPP-4 inhibitors, need to be affirmed by more good-quality RCTs (Journal of Diabetes Investigation)
Impact of SGLT2 inhibitors in comparison to DPP4 inhibitors on ascites and death in veterans with cirrhosis on metformin
In comparison to DPP4i, SGLT2i may improve survival for patients with cirrhosis who require additional pharmacotherapy for DM beyond metformin, but confirmatory studies are necessary (Diabetes, Obesity and Metabolism)
The Effects of Glucagon-Like Peptide-1 Receptor Agonists and Dipeptydilpeptidase-4 Inhibitors on Blood Pressure and Cardiovascular Complications in Diabetes
The cumulative evidence from the recent cardiovascular outcome trials suggests that the effects of GLP-1R activation have a beneficial effect on blood pressure and cardiovascular diseases. However, a robust meta-analysis is needed to compare the controversial results of the different papers in the current literature (Journal of Diabetes Research)
Glucose-lowering Drugs and Hospitalization for Heart Failure: A Systematic Review and Additive-effects Network Meta-Analysis with over 500,000 Patient-Years
The risk of HHF is reduced by SGLT2i as monotherapy or in combination with DPP4i and increased by TZD as monotherapy or in combination. Glucose-lowering provides an additive effect of reducing HHF (Journal of Clinical Endocrinology & Metabolism)
Lower Risk of Hospitalisation for Heart Failure, Kidney Disease and Death with Sodium Glucose Co‐Transporter‐2 Compared to Dipeptidyl Peptidase‐4 Inhibitors in Type 2 Diabetes Regardless of Prior Cardiovascular or Kidney Disease
SGLT2i were associated with reduced risk of all–cause mortality and hospitalisation for HF and CKD compared with DPP4–i, highlighting the need to introduce SGLT2i early in the management of T2D patients (Diabetes, Obesity and Metabolism)
Cardiovascular surrogate markers and cardiometabolic therapeutics: a viewpoint learned from clinical trials on dipeptidyl peptidase-4 inhibitors
In this commentary we discuss how we should interpret the effects of cardiometabolic therapeutics on vascular surrogate markers, based on viewpoints learned from the results of clinical trials on dipeptidyl peptidase-4 inhibitors (Cardiovascular Diabetology)
Use of Dipeptidyl Peptidase‐4 inhibitors and prognosis of COVID‐19 in hospitalized patients with type 2 diabetes: a propensity score analysis from the CORONADO study
These data support the safety of DPP‐4 inhibitors for diabetes management during the COVID‐19 pandemic and they should not be discontinued (Diabetes, Obesity and Metabolism)
Impact of Comorbidities and Glycemia at Admission and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes With COVID-19
Plasma glucose levels at admission and antidiabetes drugs may influence the survival of COVID-19 patients affected by type 2 diabetes (Diabetes Care)
Role of incretin‐based therapy in hospitalized patients with type 2 diabetes
Based on the available evidence, dipeptidyl peptidase‐4 inhibitors should be considered for hospitalized patients with type 2 diabetes and an algorithm for this is proposed (Figure 1). In relation to the use of GLP‐1 and GLP‐1 receptor agonist, further research is required to help define their role in the inpatient setting (Journal of Diabetes Investigation)
Cardiovascular outcome trials of glucose-lowering medications: an update
In summary, taking into account the findings from these new studies, it is suggested that a GLP-1RA should be offered to all people with CVD and type 2 diabetes, and SGLT2 inhibitors should be prescribed for those at high risk of heart failure or with progressive decline in eGFR. DPP4 inhibitors are a safe choice within the glucose-lowering stepped algorithm (Diabetologia)
Dipeptidyl peptidase‐4 inhibitor use is associated with decreased risk of fracture in patients with type 2 diabetes: a population‐based cohort study
The results of this study supported the premise that DPP‐4i usage is associated with a reduced risk of all‐cause fractures and upper extremity fractures in patients with type 2 diabetes (British Journal of Clinical Pharmacology)
Different Glucagon Effects During DPP-4 Inhibition versus SGLT-2 Inhibition in Metformin-Treated Type 2 Diabetes Subjects
We conclude that treatment with DPP-4 inhibition with vildagliptin results in 15% lower fasting and postprandial glucagon levels compared to SGLT-2 inhibition with dapagliflozin. DPP-4 inhibition also induces a more rapid insulin secretion and higher levels of intact incretin hormones resulting in stronger feedback inhibition of incretin hormone secretion than SGLT-2 inhibition (Diabetes, Obesity and Metabolism)
Second line initiation of insulin compared with DPP-4 inhibitors after metformin monotherapy is associated with increased risk of all-cause mortality, cardiovascular events, and severe hypoglycemia
Initiation of insulin, compared with DPP-4i treatment, was associated with an increased risk of subsequent all-cause mortality, fatal and nonfatal CVD, and severe hypoglycemia. Results from randomized trials will be important to elucidate causal relationships (Diabetes Research and Clinical Practice)
The Safety of Dipeptidyl Peptidase 4 Inhibitors and the Risk for Heart Failure
Owing to the well-documented microvascular benefit of improved glycemic control, the identification of cardiovascular-safe diabetes drugs that effectively lower glucose remains an important clinical need. The incretin therapies thus fulfill this goal. Ultimately, we need diabetes drugs that also reduce cardiovascular risk, and that will only be demonstrated through a continued commitment to long-term outcome studies (JAMA Cardiology)
Effects on Clinical Outcomes of Adding Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylureas to Metformin Therapy in Patients With Type 2 Diabetes Mellitus
Compared with sulfonylureas, DPP-4 inhibitors were associated with lower risks for all-cause death, MACEs, ischemic stroke, and hypoglycemia when used as add-ons to metformin therapy (Annals of Internal Medicine)
Safety and effectiveness of dipeptidyl peptidase-4 inhibitors versus intermediate-acting insulin or placebo for patients with type 2 diabetes failing two oral antihyperglycaemic agents
DPP-4 inhibitors were superior to placebo in reducing HbA1c levels in adults with T2DM taking at least two oral agents. Compared with placebo, no safety signals were detected with DPP-4 inhibitors and there was a reduced risk of infection. There was no significant difference in HbA1c observed between NPH and placebo or NPH and DPP-4 inhibitors (BMJ Open)
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