Safety and Efficacy of Sitagliptin Therapy for the Inpatient Management of General Medicine and Surgery Patients With Type 2 Diabetes A pilot, randomized, controlled study

• Type of Material: Article
• Authors: Guillermo Umpierrez, Emory University; David Reyes, Emory University; Sangeeta Lathkar-Pradhan, University of Michigan Health System; Francisco Pasquel, Emory University; Roma Gianchandani, University of Michigan Health System; Dawn Smiley, Emory University; Sol Jacobs, Emory University; David H. Wesorick, University of Michigan Health System; Christopher Newton, Emory University; Farnoosh Farrokhi, Emory University; Limin Peng, Emory University
• Language: English
• Date: 2013-11-01
• Publisher: American Diabetes Association
• Publication Version: Final Published Version
• Copyright Statement: © 2013 by the American Diabetes Association.
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.2337/dc13-0277
• Title of Journal or Parent Work: Diabetes Care
• ISSN: 0149-5992
• Volume: 36
• Issue: 11
• Start Page: 3430
• End Page: 3435
• Grant/Funding Information: G.E.U. is supported in part by research grants from the American Diabetes Association (7-03-CR-35) and PHS Grant UL1-RR-025008 from the Clinical and Translational Science Award program, National Institutes of Health, National Center for Research Resources.; The sponsors of this study were not involved in the study design, data collection, analysis or interpretation of the results, or preparation of the manuscript.
• Keywords: OUTCOMES; Endocrinology & Metabolism; GLYCEMIC CONTROL; HYPERGLYCEMIA; ENDOCRINOLOGY & METABOLISM; INSULIN THERAPY; Life Sciences & Biomedicine; PREVALENCE; Science & Technology; DIPEPTIDYL PEPTIDASE-4 INHIBITOR; HOSPITALIZED-PATIENTS; MORTALITY; HYPOGLYCEMIA; MELLITUS
• Research Categories: Health Sciences, Public Health; Health Sciences, General

Abstract

OBJECTIVE-This study investigated the safety and efficacy of sitagliptin (Januvia) for the inpatient management of type 2 diabetes (T2D) in general medicine and surgery patients. RESEARCHDESIGNANDMETHODSdIn this pilot, multicenter, open-label, randomized study, patients (n = 90) with a known history of T2D treated with diet, oral antidiabetic agents, or low total daily dose of insulin (#0.4 units/kg/day) were randomized to receive sitagliptin alone or in combination with glargine insulin (glargine) or to a basal bolus insulin regimen (glargine and lispro) plus supplemental (correction) doses of lispro. Major study outcomes included differences in daily blood glucose (BG), frequency of treatment failures (defined as three or more consecutive BG >240 mg/dL or a mean daily BG >240 mg/dL), and hypoglycemia between groups. RESULTS-Glycemic control improved similarly in all treatment groups. There were no differences in the mean daily BG after the 1st day of treatment (P = 0.23), number of readings within a BG target of 70 and 140 mg/dL (P = 0.53), number of BG readings >200 mg/dL (P = 0.23), and number of treatment failures (P > 0.99). The total daily insulin dose and number of insulin injections were significantly less in the sitagliptin groups compared with the basal bolus group (both P < 0.001). There were no differences in length of hospital stay (P = 0.78) or in the number of hypoglycemic events between groups (P = 0.86). CONCLUSIONS-Results of this pilot indicate that treatment with sitagliptin alone or in combination with basal insulin is safe and effective for the management of hyperglycemia in general medicine and surgery patients with T2D. © 2013 by the American Diabetes Association.