Effects of DPP-4 Inhibitors on Blood Glucose Variability in Japanese Patients with Type 2 Diabetes on Maintenance Hemodialysis: A Prospective Observational Exploratory Study

被引：4

作者：

Ishikawa-Tanaka, Tomomi ^{[1
,2
]}

Hosojima, Michihiro ^{[3
]}

Kabasawa, Hideyuki ^{[3
]}

Kaseda, Ryohei ^{[1
]}

Yasukawa, Ryota ^{[1
]}

Yata, Yusuke ^{[1
]}

Kuwahara, Shoji ^{[4
]}

Kono, Emiko ^{[5
]}

Takata, Takuma ^{[5
]}

Iino, Noriaki ^{[6
]}

Tanaka, Takahiro ^{[7
]}

Kitamura, Nobutaka ^{[7
]}

Suzuki, Yoshiki ^{[8
]}

Saito, Akihiko ^{[4
]}

Narita, Ichiei ^{[1
]}

机构：

[1] Niigata Univ, Grad Sch Med & Dent Sci, Kidney Res Ctr, Div Clin Nephrol & Rheumatol, Niigata, Japan

[2] Itoigawa Gen Hosp, Dept Internal Med, Niigata, Japan

[3] Niigata Univ, Grad Sch Med & Dent Sci, Kidney Res Ctr, Dept Clin Nutr Sci, Niigata, Japan

[4] Niigata Univ, Grad Sch Med & Dent Sci, Kidney Res Ctr, Dept Appl Mol Med, Niigata, Japan

[5] Nagaoka Chuo Gen Hosp, Dept Nephrol, Niigata, Japan

[6] Niigata Univ Med & Dent Hosp, Uonuma Inst Community Med, Dept Nephrol, Niigata, Japan

[7] Niigata Univ Med & Dent Hosp, Clin & Translat Res Ctr, Niigata, Japan

[8] Niigata Univ, Hlth Adm Ctr, Niigata, Japan

来源：

DIABETES THERAPY | 2020年 / 11卷 / 12期

关键词：

Blood glucose variability; Continuous glucose monitoring; DPP-4; inhibitors; Hemodialysis; Hypoglycemia; INSULIN-INDUCED HYPOGLYCEMIA; IMPROVES GLYCEMIC CONTROL; STAGE RENAL-DISEASE; ADD-ON TREATMENT; AUTONOMIC FAILURE; DIALYSIS; FLUCTUATIONS; THERAPY; KIDNEY; VILDAGLIPTIN;

D O I：

10.1007/s13300-020-00928-5

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction The precise blood glucose (BG) profile of hemodialysis patients is unclear, as is the effectiveness of dipeptidyl peptidase-4 (DPP-4) inhibitors in hemodialysis patients with type 2 diabetes. Here, we used continuous glucose monitoring (CGM) to evaluate BG variability in these patients and to assess the efficacy of DPP-4 inhibitors, particularly during hemodialysis sessions and at nighttime (UMIN000012638). Methods We examined BG profiles using CGM in 31 maintenance hemodialysis patients with type 2 diabetes. Differences between patients with and without DPP-4 inhibitors (n = 15 and 16, respectively) were analyzed using a linear mixed-effects model to assess changes in glucose levels in 5-min intervals. Results The model revealed that DPP-4 inhibitor use was significantly associated with suppression of a rapid drop in glucose levels, both with and without adjustment for BG levels at the start of hemodialysis. Moreover, the model revealed that the two groups differed significantly in the pattern of changes in BG levels from 0:00 to 6:55 am. DPP-4 inhibitors suppressed the tendency for subsequent nocturnal hypoglycemia. Conclusions This prospective observational exploratory study showed that DPP-4 inhibitors could suppress BG variability during hemodialysis sessions as well as subsequent nocturnal changes in patients with type 2 diabetes.

引用

页码：2845 / 2861

页数：17

共 78 条

[21] Addition of vildagliptin to insulin improves glycaemic control in type 2 diabetes [J].