In a nutshell
This article compared beta cell function (BCF) preservation with insulin vs sitagliptin (Januvia) in the management of latent autoimmune diabetes in adults (LADA). The authors concluded that BCF preservation was similar with insulin and sitagliptin in patients with LADA.
Some background
In LADA, antibodies (identifies a cell to be destroyed by our immune system) attack the beta cells of the body which make insulin. This will lead to a decrease in the number of beta cells which can make insulin and eventually patients will not be able to lower the blood glucose. Therefore, patients have to either be treated with medications which lower the blood glucose or take injectable insulin.
It is not known whether treating with oral blood glucose-lowering drugs such as sitagliptin (a dipeptidyl peptidase 4 inhibitor or DPP-4i) is better than early treatment with insulin (replaces the insulin lost from the destroyed beta cells) in patients with LADA.
Methods & findings
This study involved 64 patients with LADA. They were randomly assigned to two groups. Group 1 received injections of insulin and group 2 received oral sitagliptin tablets. The study lasted for 21 months.
At the end of the 21 months, group 1 participants had an increase in body weight by 1.9 kg. Group 2 participants decreased their body weight by 3.4 kg. There was no significant difference in BCF between the two groups (1.77 in group 1 and 1.58 in group 2).
HbA1c (blood glucose control over the past 3 months) decreased in both groups by -0.6% in group 1 and by -7.9% in group 2. Patients in both groups with low autoimmunity (amount of antibodies attacking their beta cells) did not have progressive deterioration of BCF in the 21 month period.
The bottom line
The authors concluded that BCF preservation was similar with insulin and sitagliptin in patients with LADA.
The fine print
Different laboratories might have different measurements of LADA. This might affect the results.
Published By :
Diabetes, Obesity and Metabolism
Date :
May 30, 2019
