Sitagliptin Improves the Impaired Acute Insulin Response during a Meal Tolerance Test in Japanese Patients with Type 2 Diabetes Mellitus: A Small-Scale Real-World Study

摘要

Introduction Several studies have shown that dipeptidyl peptidase-4 (DPP-4) inhibitors improve insulin secretion during oral glucose tolerance tests. However, the effects of DPP-4 inhibitors on impaired acute insulin responses in the postprandial state in real-world settings are unknown. Therefore, we evaluated the effects of sitagliptin on the acute insulin responses in Japanese patients with type 2 diabetes mellitus (T2DM) using meal tolerance tests. Methods Twenty-one patients with T2DM were given a test meal (460?kcal), and plasma glucose and insulin were measured at 0, 30, 60, 120, and 180?min after the meal. The insulinogenic index of all of these patients was below 43.2. The postprandial profiles were assessed at baseline and after 3?months of treatment with 50?mg/day sitagliptin after a meal ( n =?11) or were untreated (control group; n =?10). This study was a prospective, open-label, non-blinded, non-randomized, clinical study. Results Sitagliptin significantly decreased the plasma glucose levels at 60, 120, and 180?min, and significantly increased the plasma insulin levels at 0 and 30?min. There were no significant changes in glucose or insulin in the control group. The insulinogenic index increased significantly in the sitagliptin group compared with the control group (+16.7 vs. +0.1, P Conclusion Administration of sitagliptin at 50?mg/day after a meal improved the impaired acute insulin response and suppressed postprandial hyperglycemia. Whereas the study is rather small and the design is suboptimal as it is not randomized and not blinded, these results suggest that sitagliptin is effective in Japanese patients with T2DM, many of whom display impaired acute insulin responses after a meal.