Effects of DPP-4 Inhibitors on Hemodynamic and Metabolic Parameters in Type 2 Diabetic Patients

Abstract

Objective: To investigate the impact of sitagliptin and vildagliptin on hemodynamic and metabolic parameters in type 2 diabetic patients. Study Design: A comparative randomized clinical trial. Settings:  Outdoor patient of diabetic clinic of Sheikh Zayed medical College/ Hospital Rahim Yar Khan. Duration: Six months, July to December 2017. Methodology: Overall 120 type 2 diabetic patients with dyslipidemia and mild to moderate hypertension were randomized at diabetic clinic for treatment with sitagliptin and vildagliptin respectively for a period of 12 week. Body weight, BMI, blood pressure and serum lipid profile were analyzed pre and post treatment by using SPSS 16. Results: There was significant improvement in HbA1C after 12 weeks treatment with sitagliptin (8.1±2.2 to 6.8±3.5) vildagliptin (8.5±3.1 to 6.4±4.2) with in group. However no significant changes were observed between groups (p-0.64). This improvement in glycemic control was further accompanied by reduction in blood pressure within groups i.e. systolic (152±12.2 to 130.2±9.8 vs142±15.5 to 122±12.4) diastolic (90.5±8.4 to 80.4±6.5 vs 93±9.4 to 82.5±10.6). When comparison was done between two groups in terms of blood pressure it found to be non-significant (p=0.82 and p=0.77). Serum lipid profile also improved significantly with in groups but non significantly between groups i.e. total cholesterol (265±14.5 to 202±17.2 vs 255±14.82 to 210±14.5 p=0.12) triglycerides (210±20.5 to182±27.2 vs 192±32.5 to 148±42.55 p=0.37)LDL-cholesterol (152±14.4 to120±20.6 vs 158±15.4 to 110±9.5 p=0.86) HDL-cholesterol(42.4±3.5 to 47.4±3.8 vs 44±2.8 to 49±2.2 p=0.21)  However no significant changes were recorded in terms of body weight and body mass index(BMI) within and between both study groups. Conclusion: DPP-4 inhibitors (sitagliptin & vildagliptin) significantly improved hemodynamic and metabolic parameters in type 2 diabetic patients.