Effects of DPP-4 Inhibitors (SITAGLIPTIN and VILDAGLIPTIN) ON DIABETIC PATIENTS WITH COMORBIDITES.

Byline: Numra Siddiqua

INTRODUCTION

The number of patients with type 2 Diabetes is increasing day by day especially in Asian countries, because of an aging population and dietary habits. The management of blood glucose has become a significant medical issue. The short term goal of this disease is to control blood glucose level and the long term goals are to prevent the complications. Glycosylated hemoglobin (HbA1c) level reflects the blood glucose level over the preceding 2 months , can be used to diagnose diabetes or to evaluate blood glucose control in the patients that are already diabetic.

Clinical and observational studies reveal that reducing HbA1c has resulted in lowering the incidence of cardiovascular complications. So starting the treatment of Diabetes at the early stages thought to be important in minimizing the risks of cardiovascular events. The current Diabetes treatment program aims in lowering of HbA1c. However, recent clinical studies have found that hypoglycemia and postprandial hyperglycemia are also associated with the development of cardiovascular disease. Choice of treatment should be in the way that it should control blood glucose levels as well as HbA1c level, to reduce the risk of cardiovascular events.

DPP- 4 INHIBITORS:

DPP-4 Inhibitors (Sitagliptin and Vildagliptin) are the oral antihyperglycemic drugs that have become recently available for diabetes treatment.

COMPARION IN THE ACTIVITY OF DIFFERENT DPP4 INHIBITORS:

Sitagliptin and vildagliptin are known to have different efficacy in suppressing DPP-4 activity. Clinical study J.VICTORIA is done to compare the DPP-4 inhibitors vildagliptin and sitagliptin , using CGM (continuous glucose monitoring) to evaluate blood glucose levels and analyze the fluctuation in the blood glucose level. We also compared the cardiovascular parameters between patients taking vildagliptin and sitagliptin.

COMPARITIVE EEFICACY OF VILDAGLIPTIN and SITAGLIPTIN

The clinical trials are done on type 2 diabetes patients from Japan, when adequate glycemic control is not achieved with diet , exercise and sulphonylureas. The aim of study was to compare the efficacy of vildagliptin 50 mg twice a day versus sitagliptin 50 or 100 mg once daily.

CONCLUSION

Combining matched trials, vildagliptin 50 mg BD was associated with significantly greater absolute HbA1c reduction than sitagliptin 50 mg or 100 mg OD.

POINT TO BE NOTED

Vildagliptin plus metformin combination reduces fasting plasma glucose...