Clinical Studies On Type2Diabetic Patients Treated With Sitagliptin

Objective To explore the predictive factors of the efficacy on type2diabetic patients treated with sitagliptin. Early identification of factors associated with DPP-4inhibitors is essential to select patients and to enhance quality.Methods We collected patients’clinical information who were treated in the Department of Endocrinology, the Second Affiliated Hospital Of ShanDong University between September1,2012to June1,2014. All patients were with poor glycemic control. Sitagliptin were added while the dose and the species of patients’ antidiabetic drugs did not change. Clinial information collected were:patients’general information(gender, age, duration of diabetes, height and weight);medications patients received; conventional laboratory examination (HbAlc, Fasting plasma glucose, Post prandial glucose and C-peptide); blood lipid level(total cholesterol, Triglyceride, HDL cholesterol and LDL cholesterol);liver function(ALT, AST, et al) and renal function(BUN, creatinine, et al).We used the statistical methods to retrospectively analyze the possible factors that can be related to the changes of mean blood glucose. All statistical calculations were carried out using the software program SPSS19.0. Data with normal distribution were expressed as mean-standard deviation, otherwise were expressed as median and the range of values. Student t test was used to evaluate measurement data with normal distribution. Use the multiple liner regression analysis to find out the independent factors that may affect the efficacy of sitagliptin. P<0.05was considered as statistical different.Results (1)The mean change of FPG was1.82±0.39mmol/L while PPG decreased2.73±0.70mmol/L of all patients.(2) There was no significant difference in the decrease of FPG and PPG(neither the absolute value nor the percentage)(P>0.05). (3) Multiple liner regression analysis indicated that HbA1c was an independent factor that may affect the efficacy of sitagliptin on FPG; patients’PPG level before treatment was an independent factor that may affect the efficacy of sitagliptin on PPG.(4) There was no significant difference in the decrease of FPG and PPG beween the group of highest C peptide level and the group of lowest C peptide level(neither the absolute value nor the percentage)(P>0.05).(5) Sitagliptin significantly decreased patients’ blood glucose fluctuation(P<0.05).(6)We didn’t find any patient with severe adverse reactions after the treatment of sitagliptin. Possibility of hypoglycemia decreased.Conclusion (1) Sitagliptin was beneficial to control patients’FPG and PPG. In this observational trial we didn’t see any difference between the efficacy on FPG and PPG.(2) The efficacy of sitagliptin on FPG mainly depended on patients’HbAlc level; the efficacy of sitagliptin on PPG mainly depended on patients’PPG level before treatment.(3) The efficacy of sitagliptin on FPG and PPG probably didn’t entirely depend on the function of β cell function.(4) Sitagliptin significantly decreased patients’blood glucose fluctuation and decreased the possibility of hypoglycemia.