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Author Notes:

Professor Guillermo Umpierrez: geumpie@emory.edu

GU is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

GU wrote the initial research proposal; SC, KT, and GU wrote the manuscript; FJP, RJG, PV, SJ, MH, RAG, and VHT reviewed/edited the research proposal and manuscript and contributed to the discussion; LP conducted the statistical analysis.

GU has also received unrestricted research support for inpatient studies (to Emory University) from Merck, Novo Nordisk, AstraZeneca, Boehringer Ingelheim, and Sanofi.

FJP received research support and consulting fees from Merck; FJP has received consulting fees from Boehringer Ingelheim, Lilly, and AstraZeneca.

PV has received consulting fees from Merck and Boehringer Ingelheim.

RJG has received unrestricted research support for research studies (to Emory University) from Novo Nordisk and consulting fees from Abbott, Sanofi, and Novo Nordisk.

Authors declared no competing interests.

Subjects:

Research Funding:

This investigator-initiated study was supported by a clinical research grant from the Jacobs Research Foundation and Merck who provided sitagliptin and placebo medications.

GU is partly supported by research grants from the NIH/NATS (UL1 TR002378) from the Clinical and Translational Science Award program; and from NIH and National Center for Research Resources (1P30DK111024-01).

FJP and PV are supported by NIH grants 1K23GM128221-01A1 and 3K12HD085850-03S1 respectively.

Keywords:

  • CABG
  • DPP-4 inhibitors
  • stress hyperglycemia

Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery

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Journal Title:

BMJ Open Diabetes Research and Care

Volume:

Volume 7, Number 1

Publisher:

, Pages e000703-e000703

Type of Work:

Article | Final Publisher PDF

Abstract:

Aims: To determine if treatment with sitagliptin, a dipeptidyl peptidase-4 inhibitor, can prevent stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery. Methods: We conducted a pilot, double-blinded, placebo-controlled randomized trial in adults (18-80 years) without history of diabetes. Participants received sitagliptin or placebo once daily, starting the day prior to surgery and continued for up to 10 days. Primary outcome was differences in the frequency of stress hyperglycemia (blood glucose (BG) >180 mg/dL) after surgery among groups. Results: We randomized 32 participants to receive sitagliptin and 28 to placebo (mean age 64±10 years and HbA1c: 5.6%±0.5%). Treatment with sitagliptin resulted in lower BG levels prior to surgery (101±mg/dL vs 107±13 mg/dL, p=0.01); however, there were no differences in the mean BG concentration, proportion of patients who developed stress hyperglycemia (21% vs 22%, p>0.99), length of hospital stay, rate of perioperative complications and need for insulin therapy in the intensive care unit or during the hospital stay. Conclusion: The use of sitagliptin during the perioperative period did not prevent the development of stress hyperglycemia or need for insulin therapy in patients without diabetes undergoing CABG surgery.

Copyright information:

© Author(s) (or their employer(s)) 2019. Published by BMJ.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/).

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