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ORIGINAL ARTICLE
Year : 2016  |  Volume : 2  |  Issue : 2  |  Page : 2-4

Efficacy and safety of gliptins in patients with Type 2 Diabetes Mellitus (T2DM) and Chronic Kidney Disease (CKD)


1 Director, Institute of Renal Sciences, Global Hospital, Mumbai, 35, Dr. E. Borges road, Hospital avenue, Opposite Shirodkar High School, Parel, Mumbai 400012, India
2 Institute of Renal Sciences, Global Hospital, Mumbai, 35, Dr. E. Borges road, Hospital avenue, Opposite Shirodkar High School, Parel, Mumbai 400012, India

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Introduction: Gliptins are a new class of oral hypoglycemic agents that inhibit Dipeptidyl peptidase-4 (DPP– 4) and improve glycemic control through enhancement of the incretin axis. They are not associated with hypoglycemia and they do not cause weight gain. However, there is no Indian study about the efficacy and safety of DPP-4 inhibitors in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). The aim of the study was to determine the efficacy and safety of gliptins in patients with T2DM and CKD. Methods: Twenty nine (Male 17 and female 12) patients with T2DM and CKD (creatinine clearance < 60 ml/min) were included in the study. These subjects were started on gliptin for increasing number of hypoglycemia episodes with existing therapy (insulin and/or secretogogue). With introduction of gliptin, the dose of existing antihyperglycemic therapy was reduced. All these patients were followed for a minimum period of 6 months. The glycemic control, number of hypoglycemic episodes, weight and creatinine clearance were monitored. Results: The mean (SD) age of study subjects was 64 (11) years. The mean (SD) HBA1 c at the start of gliptin was 8.1 (1.4). After 6 months it was 7.9 (1.5). There was only 1 episode of hypoglycemia in 1 patient. The mean (SD) weight before the start of gliptin was 72.3 (10.6) kg and 6 months later it was 71.9 (10.9) kg. The mean (SD) creatinine clearance at the time of introducing gliptin was 29 (12) ml/min. After 6 months it was 28 (13) ml/min. All patients tolerated gliptin well and there was no adverse effect in any patient. Conclusion: Gliptins are effective hypoglycemic agents for T2DM with CKD. They are not associated with hypoglycemic episodes, do not cause weight gain and are well tolerated.


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