Effect of linagliptin on glucose metabolism and pancreatic beta cell function in patients with persistent prediabetes after metformin and lifestyle

Abstract The goal of the study was to evaluate the effect of adding linagliptin to metformin and lifestyle on glucose levels and pancreatic β-cell function in patients with persistent impaired glucose tolerance (IGT) after 12 months of metformin and lifestyle. A single center parallel double-blind r...

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Main Authors: Mildred Fátima de la Luz Alvarez-Canales, Sara Stephania Salazar-López, Diana Farfán-Vázquez, Yosceline Estrella Martínez-López, Jessica Noemí González-Mena, Lilia Marisela Jiménez-Ceja, Katya Vargas-Ortiz, María Lola Evia-Viscarra, María Luisa Montes de Oca-Loyola, Franco Folli, Alberto Aguilar-García, Rodolfo Guardado-Mendoza
Format: Article
Language:English
Published: Nature Portfolio 2021-04-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-88108-8
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author Mildred Fátima de la Luz Alvarez-Canales
Sara Stephania Salazar-López
Diana Farfán-Vázquez
Yosceline Estrella Martínez-López
Jessica Noemí González-Mena
Lilia Marisela Jiménez-Ceja
Katya Vargas-Ortiz
María Lola Evia-Viscarra
María Luisa Montes de Oca-Loyola
Franco Folli
Alberto Aguilar-García
Rodolfo Guardado-Mendoza
author_facet Mildred Fátima de la Luz Alvarez-Canales
Sara Stephania Salazar-López
Diana Farfán-Vázquez
Yosceline Estrella Martínez-López
Jessica Noemí González-Mena
Lilia Marisela Jiménez-Ceja
Katya Vargas-Ortiz
María Lola Evia-Viscarra
María Luisa Montes de Oca-Loyola
Franco Folli
Alberto Aguilar-García
Rodolfo Guardado-Mendoza
author_sort Mildred Fátima de la Luz Alvarez-Canales
collection DOAJ
description Abstract The goal of the study was to evaluate the effect of adding linagliptin to metformin and lifestyle on glucose levels and pancreatic β-cell function in patients with persistent impaired glucose tolerance (IGT) after 12 months of metformin and lifestyle. A single center parallel double-blind randomized clinical trial with 6 months of follow-up was performed in patients with persistent IGT after 12 months of treatment with metformin and lifestyle; patients were randomized to continue with metformin 850 mg twice daily (M group, n = 12) or linagliptin/metformin 2.5/850 mg twice daily (LM group, n = 19). Anthropometric measurements were obtained by standard methods and by bioelectrical impedance; glucose was measured by dry chemistry, insulin by chemiluminescence, and pancreatic β-cell function was calculated with the disposition index using glucose and insulin values during oral glucose tolerance test (OGTT) and adjusting by insulin sensitivity. The main outcomes were glucose levels during OGTT and pancreatic β-cell function. Patients in the LM group had a reduction in weight (−1.7 ± 0.6, p < 0.05) and body mass index (BMI, −0.67 ± 0.2, p < 0.05). Glucose levels significantly improved in LM group with a greater reduction in the area under the glucose curve during OGTT (AUCGluc0_120min) as compared to the M group (−4425 ± 871 vs −1116 ± 1104 mg/dl/120 min, p < 0.001). Pancreatic β-cell function measured with the disposition index, improved only in LM group (2.3 ± 0.23 vs 1.7 ± 0.27, p 0.001); these improvements persisted after controlling for OGTT glucose levels. The differences in pancreatic β-cell function persisted also after pairing groups for basal AUCGluc0_120min. The addition of linagliptin to patients with persistent IGT after 12 months of treatment with metformin and lifestyle, improved glucose levels during OGTT and pancreatic β-cell function after 6 months of treatment. Trial registration: Clinicaltrials.gov with the ID number NCT04088461
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spelling doaj.art-8a85352854e042bdac3e622b33f7667c2022-12-21T20:34:13ZengNature PortfolioScientific Reports2045-23222021-04-0111111010.1038/s41598-021-88108-8Effect of linagliptin on glucose metabolism and pancreatic beta cell function in patients with persistent prediabetes after metformin and lifestyleMildred Fátima de la Luz Alvarez-Canales0Sara Stephania Salazar-López1Diana Farfán-Vázquez2Yosceline Estrella Martínez-López3Jessica Noemí González-Mena4Lilia Marisela Jiménez-Ceja5Katya Vargas-Ortiz6María Lola Evia-Viscarra7María Luisa Montes de Oca-Loyola8Franco Folli9Alberto Aguilar-García10Rodolfo Guardado-Mendoza11Department of Medicine and Nutrition, University of GuanajuatoDepartment of Medicine and Nutrition, University of GuanajuatoDepartment of Medicine and Nutrition, University of GuanajuatoDepartment of Medicine and Nutrition, University of GuanajuatoDepartment of Medicine and Nutrition, University of GuanajuatoDepartment of Medicine and Nutrition, University of GuanajuatoDepartment of Medical Sciences, University of GuanajuatoEndocrinology Department Hospital Regional de Alta Especialidad del BajíoDepartment of Medicine and Nutrition, University of GuanajuatoEndocrinology and Metabolism Dipartimento Di Scienze Della Salute, Universita’ Degli Studi Di MilanoEndocrinology Department Hospital Regional de Alta Especialidad del BajíoDepartment of Medicine and Nutrition, University of GuanajuatoAbstract The goal of the study was to evaluate the effect of adding linagliptin to metformin and lifestyle on glucose levels and pancreatic β-cell function in patients with persistent impaired glucose tolerance (IGT) after 12 months of metformin and lifestyle. A single center parallel double-blind randomized clinical trial with 6 months of follow-up was performed in patients with persistent IGT after 12 months of treatment with metformin and lifestyle; patients were randomized to continue with metformin 850 mg twice daily (M group, n = 12) or linagliptin/metformin 2.5/850 mg twice daily (LM group, n = 19). Anthropometric measurements were obtained by standard methods and by bioelectrical impedance; glucose was measured by dry chemistry, insulin by chemiluminescence, and pancreatic β-cell function was calculated with the disposition index using glucose and insulin values during oral glucose tolerance test (OGTT) and adjusting by insulin sensitivity. The main outcomes were glucose levels during OGTT and pancreatic β-cell function. Patients in the LM group had a reduction in weight (−1.7 ± 0.6, p < 0.05) and body mass index (BMI, −0.67 ± 0.2, p < 0.05). Glucose levels significantly improved in LM group with a greater reduction in the area under the glucose curve during OGTT (AUCGluc0_120min) as compared to the M group (−4425 ± 871 vs −1116 ± 1104 mg/dl/120 min, p < 0.001). Pancreatic β-cell function measured with the disposition index, improved only in LM group (2.3 ± 0.23 vs 1.7 ± 0.27, p 0.001); these improvements persisted after controlling for OGTT glucose levels. The differences in pancreatic β-cell function persisted also after pairing groups for basal AUCGluc0_120min. The addition of linagliptin to patients with persistent IGT after 12 months of treatment with metformin and lifestyle, improved glucose levels during OGTT and pancreatic β-cell function after 6 months of treatment. Trial registration: Clinicaltrials.gov with the ID number NCT04088461https://doi.org/10.1038/s41598-021-88108-8
spellingShingle Mildred Fátima de la Luz Alvarez-Canales
Sara Stephania Salazar-López
Diana Farfán-Vázquez
Yosceline Estrella Martínez-López
Jessica Noemí González-Mena
Lilia Marisela Jiménez-Ceja
Katya Vargas-Ortiz
María Lola Evia-Viscarra
María Luisa Montes de Oca-Loyola
Franco Folli
Alberto Aguilar-García
Rodolfo Guardado-Mendoza
Effect of linagliptin on glucose metabolism and pancreatic beta cell function in patients with persistent prediabetes after metformin and lifestyle
Scientific Reports
title Effect of linagliptin on glucose metabolism and pancreatic beta cell function in patients with persistent prediabetes after metformin and lifestyle
title_full Effect of linagliptin on glucose metabolism and pancreatic beta cell function in patients with persistent prediabetes after metformin and lifestyle
title_fullStr Effect of linagliptin on glucose metabolism and pancreatic beta cell function in patients with persistent prediabetes after metformin and lifestyle
title_full_unstemmed Effect of linagliptin on glucose metabolism and pancreatic beta cell function in patients with persistent prediabetes after metformin and lifestyle
title_short Effect of linagliptin on glucose metabolism and pancreatic beta cell function in patients with persistent prediabetes after metformin and lifestyle
title_sort effect of linagliptin on glucose metabolism and pancreatic beta cell function in patients with persistent prediabetes after metformin and lifestyle
url https://doi.org/10.1038/s41598-021-88108-8
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