Incretin-based therapy can improve glucose control in type 2 diabetes (T2D) with no weight gain. Usually dipeptidyl peptidase-IV (DPP-IV) inhibitors considered as weight neutral and glucagon-like peptide-1 receptor agonists are associated with weight loss. Some trials showed non-remarkable weight-lowering effect on DPP-IV inhibitors. We aimed to identify patients on DPP-IV inhibitors which are likely to achieve both outcomes either good glycaemic control or weight loss.
We studied 89 (58F/31M) T2D drug-naïve patients treated with metformin 10002000 mg/24 plus sitagliptin 100 mg/24 for 26 weeks. The age was 57.1+6.5 y (M+SD), A1c −8.4+1.0%. 44 patients with weight more then 100 kg (Group 1) were compared with 45 controls from Group 2 (weight less then 100 kg). Groups were matched for gender and age.
At the beginning patients from Group 1 on average were approximately 25 kg heavier: 113.3+6.49 kg vs. 88.2+6.13 kg in Group 2 (BMI 39.1+3.25 kg/m2 vs. 30.4+3.28 kg/m2 respectively). After 26 weeks of treatment A1c not differed between groups (7.20+0.18% vs. 7.15+0.20%). At the same time change in weight in Group 1 reached (−)3.2 kg (from 113.27+6.49 kg to 110.05+6.96 kg) and was significant. In Group 2 twice less weight lowering effect was observed (from 88.22+6.13 kg to 86.56+6.23 kg) and there was no significant difference. Moreover, weight reduction more then 3% (from 4 up to 14 kg) was seen in 18 from 44 patients (40.9%) in Group 1 and only in 10 (from 3 to 6 kg) from 45 patients (22.2%) in Group 2 (P<0.05).
We concluded the glycaemic control in T2D patients on DPP-IV inhibitors could be associated with remarkable weight loss. The composite outcome is more likely to be achieved in very obese persons.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
05 - 09 May 2012
European Society of Endocrinology