Dipeptidyl Peptidase-4 Inhibitor (Vildagliptin) Improves Glycemic Control After Meal Tolerance Test by Suppressing Glucagon Release |
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Authors: | Aki Okamoto Hirohide Yokokawa Hironobu Sanada |
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Affiliation: | .OKM Okamoto Medical Clinic, Tokyo, Japan ;.Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan ;.Division of Health Science Research, Fukushima Welfare Federation of Agricultural Cooperatives, Fukushima, Japan ;.Department of Tumor and Host Bioscience, Fukushima Medical University School of Medicine, Fukushima, Japan |
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Abstract: | AimWe aimed to evaluate changes in insulin and glucagon secretion, as well as glucose levels, with a meal tolerance test (MTT) before and after 6 months of treatment with vildagliptin in a clinical setting.Materials and MethodsParticipants were 15 patients with uncontrolled type 2 diabetes mellitus (glycated hemoglobin [HbA1c] over 6.9 % for more than 3 months). MTTs were conducted before and 6 months after addition of vildagliptin (50 mg twice daily [bid]). Blood samples were collected immediately before, and 1 and 2 h after the test meal for measurement of blood glucose concentration, immune-reactive insulin (IRI), and glucagon. HbA1c was measured at 6 months.ResultsMean age of participants was 55.5 ± 2.8 years, and ten (66.7 %) were male. Mean HbA1c significantly improved from 7.6 to 6.8 % at 6 months after addition of vildagliptin. Blood glucose at 1 and 2 h after the test meal was significantly reduced after addition of vildagliptin, while the reduction in glucagon showed borderline significance and IRI showed no difference. In a comparison of blood glucose-related parameters between subgroups based on median glucose change in area under the curve during MTT (ΔAUC0–2h), glucagon ΔAUC0–2h was significantly lower in the group with more improved glucose levels (ΔAUC0–2h ≥65 mg/dL), but that of IRI did not differ.ConclusionSuppression of glucagon release by vildagliptin may improve glycemic control without increasing insulin levels in patients with type 2 diabetes. |
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