Abstract
BackgroundThere are few studies evaluating long-term glycemic control using a dipeptidyl peptidase-4 inhibitor in type 2 diabetes patients with end-stage renal disease (ESRD). The aim of this study was to evaluate the safety and efficacy of vildagliptin therapy over 2 years in type 2 diabetes with ESRD.MethodsPatients with ESRD resulting from type 2 diabetes requiring dialysis who had ≥20 % glycated albumin (GA) were enrolled. Vildagliptin 50 mg once daily was administered for 2 years. Changes in GA and dry weight were evaluated.ResultsIn 32 patients (24 men and 8 women) aged 68.3 ± 1.9 years, vildagliptin 50 mg once daily was administered for 2 years, but the dose was increased to 50 mg twice daily in 15 patients. GA was significantly reduced by 2.6 ± 0.6 %, from 22.4 ± 0.6 % at baseline to 19.8 ± 0.4 % at 2 years. After 2 years of vildagliptin therapy, 15 (46.9 %) of 32 patients achieved a GA level of <20 %. Dry weight changed slightly, with an increase of 1.3 ± 0.8 kg at 2 years. No adverse drug reactions related to treatment with vildagliptin were seen.ConclusionsVildagliptin is a promising therapeutic option for safe, effective glycemic control in type 2 diabetic patients with ESRD.
Highlights
There are few studies evaluating long-term glycemic control using a dipeptidyl peptidase-4 inhibitor in type 2 diabetes patients with end-stage renal disease (ESRD)
It has been reported that persistent hyperglycemia is correlated with increased mortality in type 2 diabetic patients with ESRD, and strict glycemic control contributes to reduced mortality in this group [3]
Since glucose metabolism is modified by renal function, hypoglycemia often occurs in the treatment of diabetic patients with ESRD
Summary
There are few studies evaluating long-term glycemic control using a dipeptidyl peptidase-4 inhibitor in type 2 diabetes patients with end-stage renal disease (ESRD). The aim of this study was to evaluate the safety and efficacy of vildagliptin therapy over 2 years in type 2 diabetes with ESRD. Diabetes is a risk factor for chronic kidney disease, and strict glycemic control in the management of diabetes can slow the progression of nephropathy [1]. The number of patients with end-stage renal disease (ESRD) requiring hemodialysis is increasing linearly in Japan, and diabetic nephropathy accounts for ≥40 % of the underlying disease [2]. It has been reported that persistent hyperglycemia is correlated with increased mortality in type 2 diabetic patients with ESRD, and strict glycemic control contributes to reduced mortality in this group [3]. Insulin and some oral antidiabetic agents are available for the treatment of these patients, often complicating the process of treatment selection
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