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Comparing the Effect of Dipeptidyl-Peptidase 4 Inhibitors and Sulfonylureas on Albuminuria in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A Prospective Open-Label Study.

Authors
  • Cheng, Po-Chung1
  • Hsu, Shang-Ren2
  • Kuo, Jeng-Fu3
  • Cheng, Yun-Chung4
  • Liu, Yu-Hsiu5
  • Tu, Shih-Te6
  • 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanxiao Street., Changhua City, Changhua County 500, Taiwan. [email protected] , (Taiwan)
  • 2 Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanxiao Street., Changhua City, Changhua County 500, Taiwan. [email protected] , (Taiwan)
  • 3 Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanxiao Street., Changhua City, Changhua County 500, Taiwan. [email protected] , (Taiwan)
  • 4 Department of Radiology, Taichung Veterans General Hospital, Taichung Veterans General Hospital, Section 4, No. 1650, Taiwan Boulevard, Taichung, Taiwan. [email protected] , (Taiwan)
  • 5 Department of Accounting and Information Systems, National Taichung University of Science and Technology, 129 San Min Road., Taichung, Taiwan. [email protected] , (Taiwan)
  • 6 Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanxiao Street., Changhua City, Changhua County 500, Taiwan. [email protected] , (Taiwan)
Type
Published Article
Journal
Journal of Clinical Medicine
Publisher
MDPI AG
Publication Date
Oct 17, 2019
Volume
8
Issue
10
Identifiers
DOI: 10.3390/jcm8101715
PMID: 31627406
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Diabetic kidney disease (DKD) leads to substantial morbidity in patients with type 2 diabetes mellitus (T2DM). Evidence suggests that antidiabetic drug dipeptidyl-peptidase 4 (DPP-4) inhibitors may be able to attenuate albuminuria, whereas the influence of sulfonylureas on albuminuria remains unclear. This prospective open-label study investigated the effect of DPP-4 inhibitors and sulfonylureas on urinary albumin excretion, which is a marker of renal microvascular abnormality. A total of 101 participants with newly diagnosed T2DM were enrolled. In addition to metformin therapy, 45 patients were assigned to receive DPP-4 inhibitors and 56 to receive sulfonylureas. Urinary albumin-to-creatinine ratio (ACR) was significantly reduced in recipients of DPP-4 inhibitors after 24 weeks (29.2 µg/mg creatinine vs. 14.9 µg/mg creatinine, P < 0.001), whereas urinary ACR was not significantly changed by sulfonylureas (39.9 µg/mg creatinine vs. 43.2 µg/mg creatinine, P = 0.641). The effect on albuminuria occurred even though both treatment groups had a similar change in serum glycated hemoglobin A1c (-1.87 % vs.-2.40 %, P = 0.250). Therefore, in diabetic patients the addition of DPP-4 inhibitors lowered urinary albumin excretion compared to sulfonylureas, and attenuation of albuminuria may be a consideration when choosing between antidiabetic medications.

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