Efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus: A focus on hypoglycemia
Abstract Aims/Introduction To investigate the efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus, with a focus on hypoglycemia. Materials and Methods Type 2 diabetes mellitus patients who started sitagliptin therapy and were followed for 52 weeks were enrolled in th...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-03-01
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| Series: | Journal of Diabetes Investigation |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jdi.12915 |
| _version_ | 1818574852422893568 |
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| author | Masahiro Fukuda Kunihiro Doi Masahiro Sugawara Koichi Mochizuki |
| author_facet | Masahiro Fukuda Kunihiro Doi Masahiro Sugawara Koichi Mochizuki |
| author_sort | Masahiro Fukuda |
| collection | DOAJ |
| description | Abstract Aims/Introduction To investigate the efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus, with a focus on hypoglycemia. Materials and Methods Type 2 diabetes mellitus patients who started sitagliptin therapy and were followed for 52 weeks were enrolled in the Impact of Sitagliptin on Diabetes Mellitus in Japanese Elderly Patients study. The frequency of hypoglycemia and knowledge of hypoglycemia were analyzed using a questionnaire. Results In total, 5,130 patients (aged 73.8 ± 6.1 years) were analyzed. A significant reduction in glycated hemoglobin (−0.7 ± 1.1%, P < 0.001) and glycoalbumin levels (−2.2 ± 3.8%, P < 0.001) was observed at week 52. The percentage of patients with hypoglycemia did not increase from the baseline (3.3%) to week 52 (2.8%) of sitagliptin administration. Hypoglycemia incidence was significantly higher for combination therapy with insulin (odds ratio 17.75, P < 0.001) or sulfonylurea (odds ratio 2.22, P < 0.001). The increase in sitagliptin dose for combination therapy with antidiabetic drug(s) increased the percentage of patients with hypoglycemia (5.6% in sitagliptin increased subgroup, 2.4% in sitagliptin maintained subgroup, P < 0.01). The awareness of hypoglycemia symptoms and attitude to carry glucose as a countermeasure to prevent hypoglycemia increased during the study. Conclusions Sitagliptin did not increase the percentage of patients with hypoglycemia among elderly patients with type 2 diabetes mellitus. However, hypoglycemia occurred more frequently in add‐on therapy to sulfonylurea or when the sitagliptin dose was increased in combination therapy, showing that sitagliptin should be used with caution. |
| first_indexed | 2024-12-15T00:31:36Z |
| format | Article |
| id | doaj.art-cfb2385f59b94279bf2f0a8217d3715f |
| institution | Directory Open Access Journal |
| issn | 2040-1116 2040-1124 |
| language | English |
| last_indexed | 2024-12-15T00:31:36Z |
| publishDate | 2019-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj.art-cfb2385f59b94279bf2f0a8217d3715f2022-12-21T22:42:00ZengWileyJournal of Diabetes Investigation2040-11162040-11242019-03-0110238339110.1111/jdi.12915Efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus: A focus on hypoglycemiaMasahiro Fukuda0Kunihiro Doi1Masahiro Sugawara2Koichi Mochizuki3Fukuda Clinic OsakaJapanDoi Clinic KyotoJapanSugawara Clinic Tokyo JapanMochizuki Naika Clinic Tokyo JapanAbstract Aims/Introduction To investigate the efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus, with a focus on hypoglycemia. Materials and Methods Type 2 diabetes mellitus patients who started sitagliptin therapy and were followed for 52 weeks were enrolled in the Impact of Sitagliptin on Diabetes Mellitus in Japanese Elderly Patients study. The frequency of hypoglycemia and knowledge of hypoglycemia were analyzed using a questionnaire. Results In total, 5,130 patients (aged 73.8 ± 6.1 years) were analyzed. A significant reduction in glycated hemoglobin (−0.7 ± 1.1%, P < 0.001) and glycoalbumin levels (−2.2 ± 3.8%, P < 0.001) was observed at week 52. The percentage of patients with hypoglycemia did not increase from the baseline (3.3%) to week 52 (2.8%) of sitagliptin administration. Hypoglycemia incidence was significantly higher for combination therapy with insulin (odds ratio 17.75, P < 0.001) or sulfonylurea (odds ratio 2.22, P < 0.001). The increase in sitagliptin dose for combination therapy with antidiabetic drug(s) increased the percentage of patients with hypoglycemia (5.6% in sitagliptin increased subgroup, 2.4% in sitagliptin maintained subgroup, P < 0.01). The awareness of hypoglycemia symptoms and attitude to carry glucose as a countermeasure to prevent hypoglycemia increased during the study. Conclusions Sitagliptin did not increase the percentage of patients with hypoglycemia among elderly patients with type 2 diabetes mellitus. However, hypoglycemia occurred more frequently in add‐on therapy to sulfonylurea or when the sitagliptin dose was increased in combination therapy, showing that sitagliptin should be used with caution.https://doi.org/10.1111/jdi.12915HypoglycemiaSitagliptinSulfonylurea |
| spellingShingle | Masahiro Fukuda Kunihiro Doi Masahiro Sugawara Koichi Mochizuki Efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus: A focus on hypoglycemia Journal of Diabetes Investigation Hypoglycemia Sitagliptin Sulfonylurea |
| title | Efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus: A focus on hypoglycemia |
| title_full | Efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus: A focus on hypoglycemia |
| title_fullStr | Efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus: A focus on hypoglycemia |
| title_full_unstemmed | Efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus: A focus on hypoglycemia |
| title_short | Efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus: A focus on hypoglycemia |
| title_sort | efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus a focus on hypoglycemia |
| topic | Hypoglycemia Sitagliptin Sulfonylurea |
| url | https://doi.org/10.1111/jdi.12915 |
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