Association between sitagliptin plus vitamin D3 (VIDPP-4i) use and clinical remission in patients with new-onset type 1 diabetes: a retrospective case-control study

ABSTRACT Objective: The occurrence of partial remission (honeymoon phase) in type 1 diabetes (T1D) has been associated with a reduced risk of chronic microvascular complications of diabetes. We have published case reports showing that a combination therapy with the DPP-4 inhibitor sitagliptin plus...

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Main Authors: Marcelo Maia Pinheiro, Felipe Moura Maia Pinheiro, Marcelo Müller de Arruda, Geane Moron Beato, Graciele Alves Corrêa Lima Verde, Georgiana Bianchini, Pedro Rosário Moraes Casalenuovo, Aline Aparecida Agostini Argolo, Lucilene Telles de Souza, Flávia Gomes Pessoa, Thiago Santos Hirose, Eduardo Filgueiras Senra, Camillo Ricordi, Andrea Fabbri, Marco Infante, Susana Nogueira Diniz
Format: Article
Language:English
Published: Brazilian Society of Endocrinology and Metabolism 2023-06-01
Series:Archives of Endocrinology and Metabolism
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000500214&lng=en&tlng=en
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Summary:ABSTRACT Objective: The occurrence of partial remission (honeymoon phase) in type 1 diabetes (T1D) has been associated with a reduced risk of chronic microvascular complications of diabetes. We have published case reports showing that a combination therapy with the DPP-4 inhibitor sitagliptin plus vitamin D3 (VIDPP-4i) can prolong the honeymoon phase in patients with new-onset T1D. In the present case-control study, we investigated the frequency of occurrence of clinical remission (CR) in patients with new-onset T1D after VIDPP-4i treatment. Subjects and methods: In this case-control study, we collected data spanning 10 years from medical records of 46 patients (23 females) recently diagnosed with T1D. Overall, 27 participants with CR (insulin dose-adjusted glycated hemoglobin [IDAA1c] ≤ 9) at 12 or 24 months composed the case group, and 19 participants without CR served as the control group. Chi-square with Yates correction was used to analyze the association between VIDPP-4i use and CR, and odds ratio (OR) was used to determine the chance of CR due to VIDPP-4i treatment exposure. Results: In all, 37 patients (80.4%) experienced CR at some time over 24 months. The mean CR duration was 13.15 ± 9.91 months. Treatment with VIDPP-4i was significantly associated with CR. At 24 months, the OR of CR after VIDPP-4i exposure was 9.0 (95% confidence interval [CI] 2.21-30.18, p = 0.0036). Additionally, 9 (33.6%) and 4 (14.8%) patients in the VIDPP-4i group experienced insulin-free CR at 12 and 24 months, respectively. Conclusion: Therapy with VIDPP-4i was associated with a higher frequency and duration of the honeymoon phase. Randomized controlled trials are needed to confirm these findings.
ISSN:2359-4292