Sitagliptin is safe and effective for Asian type 2 diabetes patients

This study examined the safety and effectiveness of the addition of sitagliptin (Januvia) to insulin therapy in Asian type 2 diabetes patients. 

Type 2 diabetes is a progressive disease. While blood glucose (sugar) levels can often first be controlled with diet and exercise alone, patients will need to add glucose-lowering medications and, eventually, insulin therapy. However, insulin therapy can increase the risk of hypoglycemia (dangerously low blood glucose).

Dipeptidyl peptidase-4 (DPP-4) inhibitors, such as sitagliptin, increase the amount of insulin produced by the body in response to glucose. DPP-4 inhibitors can improve blood glucose control without increasing the risk of hypoglycemia. However, many of the studies examining DPP-4 inhibitors have been carried out on Caucasion patients. DPP-4 inhibitors such as sitagliptin can lead to larger decreases in glucose in Asian type 2 diabetes patients. Therefore, the safety and effectiveness of sitagliptin needs to be examined in this population.

This study examined the safety and effectiveness of adding sitagliptin in Asian type 2 diabetes patients whose blood glucose was not controlled by insulin alone. In this study, 49 patients were randomly assigned to receive insulin plus sitagliptin (Group 1; 25 patients) or insulin alone (Group 2; 24 patients) for 24 weeks. The difference in HbA1c (average blood glucose over 3 months) and post-meal glucose levels (glucose levels measured at certain times prior to and following a meal) were measured at the start of the study (baseline) and at 24 weeks.

Average HbA1c decreased significantly, from 7.9% at baseline to 7.0% at 24 weeks, in Group 1. HbA1c did not change in Group 2. At 24 weeks, average HbA1c levels were 0.9% lower in patients in Group 1 compared to patients in Group 2.

Glucose levels following a meal did not change after 24 weeks in Group 2. In Group 1, glucose levels at 30, 60, 90, and 120 minutes following a meal were all significantly decreased after 24 weeks of treatment. Both daily insulin doses and rates of hypoglycemia were significantly reduced in patients in Group 1 compared to patients in Group 2.

This study concluded that adding sitagliptin to insulin therapy was a safe and effective way to lower blood glucose levels in Asian type 2 diabetes patients.