J Korean Med Sci.  2013 Jun;28(6):881-887. 10.3346/jkms.2013.28.6.881.

Clinical Characteristics of the Responders to Dipeptidyl Peptidase-4 Inhibitors in Korean Subjects with Type 2 Diabetes

• Oh TJ
• Jung HS
• Bae JH
• Kim YG
• Park KS
• Cho YM
• Park KS
• Kim SY

• KMID: 2158036
• DOI: http://doi.org/10.3346/jkms.2013.28.6.881

Abstract

We investigated characteristics associated with the efficacy of dipeptidyl peptidase-4 inhibitors (DPP4i) in Korean patients with type 2 diabetes. We reviewed medical records of 477 patients who had taken sitagliptin or vildagliptin longer than 40 weeks. Response to DPP4i was evaluated with HbA1c change after therapy (DeltaHbA1c). The Student's t-test between good responders (GR: DeltaHbA1c > 1.0%) and poor responders (PR: DeltaHbA1c < 0.5%), a correlation analysis among clinical parameters, and a linear multivariate regression analysis were performed. The mean age was 60 yr, duration of diabetes 11 yr and HbA1c was 8.1%. Baseline fasting plasma glucose (FPG), HbA1c, C-peptide, and creatinine were significantly higher in the GR compared to the PR. Duration of diabetes, FPG, HbA1c, C-peptide and creatinine were significantly correlated with DeltaHbA1c. In the multivariate analysis, age (r2 = 0.006), duration of diabetes (r2 = 0.019), HbA1c (r2 = 0.296), and creatinine levels (r2 = 0.024) were independent predictors for the response to DPP4i. Body mass index and insulin resistance were not associated with the response to DPP4i. In conclusion, better response to DPP4i would be expected in Korean patients with type 2 diabetes who have higher baseline HbA1c and creatinine levels with shorter duration of diabetes.

Keyword

Dipeptidyl Peptidase IV Inhibitors; Diabetes Mellitus, Type 2; Hemoglobin A, Glycosylated; Clinical Efficacy

MeSH Terms

Adamantane/*analogs & derivatives/therapeutic use
Blood Glucose/analysis
Body Mass Index
C-Peptide/analysis
Creatinine/blood
Diabetes Mellitus, Type 2/*drug therapy/pathology
Dipeptidyl-Peptidase IV Inhibitors/*therapeutic use
Hemoglobin A, Glycosylated/analysis
Humans
Insulin Resistance
Male
Middle Aged
Multivariate Analysis
Nitriles/*therapeutic use
Pyrazines/*therapeutic use
Pyrrolidines/*therapeutic use
Retrospective Studies
Triazoles/*therapeutic use
Blood Glucose
C-Peptide
Dipeptidyl-Peptidase IV Inhibitors
Hemoglobin A, Glycosylated
Nitriles
Pyrazines
Pyrrolidines
Triazoles
Creatinine
Adamantane

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