DPP-4 inhibitor use in type 2 diabetes and the risk of diabetic eye disease

This study aimed to investigate if the use of DPP-4 inhibitor drugs for the treatment of type 2 diabetes (T2D) was harmful or helpful in diabetic retinopathy (DR; eye disease). The main finding of this study was that DPP-4 inhibitors did not increase the overall risk of DR.

DPP-4 inhibitors (DPP4i) are a type drug used to treat T2D. Some of the drugs in this category include sitagliptin (Januvia), Vildagliptin (Galvus), Saxagliptin (Onglyza), Linagliptin (Tradjenta). They increase the amount of insulin (the hormone that controls blood sugar) in the body. This helps lower blood glucose levels.

There are many different complications associated with T2D, including cardiovascular (heart and blood vessels) disease. These also include DR, a disease that affects the small blood vessels in the eye. In previous studies, DPP4is have shown to not aggravate cardiovascular disease in patients with T2D. However, the effects of DPP4i on DR are still under investigation.

The data of 14,552 patients with T2D who were taking DPP4i were studied. These patients were compared to the same number with similar patients with T2D who had never used a DPP4i. Patients were followed up for an average of 28.4 months.

Treatment with a DPP4i was not associated with an increased risk of DR. However, DPP4i treatment for less than 12 months was associated with a 31% increased risk of early changes in the eye compared to those not taking a DPP4i. The use of DPP4i for more than 12 months was not associated with an increased risk of DR.

The authors concluded that compared to other anti-diabetic drugs, DPP4is did not increase the risk of DR. However, they may be associated with DR changes in the early stages of treatment.

The study did not include information on the severity of DR and patients had different levels of blood glucose control. This might have influenced the results.