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Vildagliptin and its role in the treatment of diabetes mellitus

Abstract

Type 2 diabetes mellitus is a most serious medical problem throughout the world. Traditional hypoglycemic agents do not ensure long-term control ofglycemia and fail to affect the natural course of DM. An ideal hypoglycemic medicine must be efficacious, safe, and convenient to use for the preventionof progressive deterioration of beta-cell function during prolonged therapy; also, it should have positive effect on the outcome of DM. The use of incretinsin the recent decade is a new promising approach to the management of DM2. The group of incretins includes gastrointestinal hormones released inresponse to food intake to stimulate insulin secretion. Dipeptidyl peptidase-4 (DPP-4) inhibitors, a new class of hypoglycemic agents, have been inuse in this country for over 3 years. Vildaglyptin (Galvus) is a representative of DPP-4 inhibitors and GalvusMet is the sole combination of DPP-4inhibitor with metformin registered in Russia. The advent of incretin mimetics necessiatate revision of national and international guidelines for DM2therapy. Results of international clinical studies show that Galvus and GalvusMet are efficacious and safe, they ensure adequate control of glycemiafree from complications and side effects. An important advantage of these preparations is the possibility of their use by elderly patients with arterialhypertension and moderate renal dysfunction and by those at risk of cardiovascular disorders. The evidence-based Galvus information is highly convincing.The advantages of Galvus over traditional agents give reason to recommend it as a medicine of choice for the initiation of DM2 therapy. Approvedcombinations of Galvus with other hypoglycemic agents may be used at all stages of intensive therapy of DM2.

About the Author

Yury Shavkatovich Khalimov
Военно-медицинская академия им. С.М. Кирова, Санкт-Петербург


References

1. Дедов И.И., Шестакова М.В. Инкретины: новая веха в лечении са- харного диабета 2 типа. - М.: Дипак, 2010 - 92 с.

2. Del Prato S., Felton A., Munro N. et al. On behalf of the Global Partnership for Effective Diabetes Management: Improving glucose management: Ten steps to get more patients with type 2 to glucose goal // Int. J. Clin. Pract. - 2005. - Vol. 59. - P. 1345-1355.

3. Stratton I.M., Adler A.I., Neil H.A. et al. Association of glycaemia with macrovascular and microvascular complications of type 2 dia-betes (UKPDS 35): prospective observational study // BMJ. - 2000. - Vol. 321. - P. 405-412.

4. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) // Lancet. - 1998. - Vol. 352 (9131). - P. 837-853.

5. Kahn S.E., Haffner S.M., Heise M.A. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy // NEJM. - 2006. - Vol. 355(23). - P. 2427-2443.

6. Nauck M.A., Homberger E., Siegel E.G. et al. Incretin effects of increasing glucose loads in man calculated from venous insulin and C-peptide responses // J. Clin. Endocrinol. Metab. - 1986. - Vol. 63. - P. 492- 498.

7. Xu G., Stoffers D.A., Habener J.F. et al. Exendin-4 stimulates both-cell replication and neogenesis, resulting in increased -cell mass and improved glucose tolerance in diabetic rats // Diabetes. - 1999.- Vol. 48. - P. 2270-2276.

8. Stoffers D.A., Kieffer T.J., Hussain M.A. et al. Insulinotropic glucagon-like peptide-1 agonists stimulate expression of homeodomain protein IDX-1 and increase islet size in mouse pancreas // Diabetes. - 2000. Vol. 49. - P. 741-748.

9. Holst J. The physiology and pharmacology of incretins in type 2 diabetes. // Diabetes Obes. Metab. 2008. - Vol. 10 (Suppl 3). - P. 14-21.

10. www.nice.org.uk/nicemedia/live/11983/40803/40803.pdf

11. Nathan D.M., Buse J.B., Davidson M.B. et al. Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Associa-tion for the Study of Diabetes // Diabetes Care 2008. - Vol. 31. - P. 1-11.

12. Edwards C.M.B., Winocour P.H. ABCD position statement on in-cretinmimetics and DPP-4 inhibitors - 2009 // Practical Diabetes Int. - 2009. Vol. 26(5). - P. 191-194.

13. http://www.nice.org.uk/nicemedia/live/12165/44318/44318.pdf.

14. ААСЕ Statement by an American Association of Clinical Endocrinologists / American College of Endocrinology Consensus Pane l on Type 2 Diabetes Mellitus: An Algorithm for Glycemic Control // Endocr. Pract. - 2009. - Vol. 15(6). - P. 540-549.

15. http://www.clinicaltrials.gov/ct2/results?term=vildagliptin.

16. Schweizer A., Couturier A., Foley J.E. et al. Comparison between vildagliptin and metformin to sustain reductions in HbA1c over 1 year in drugnaïve patients with type 2 diabetes // Diabet. Med. - 2007. - Vol. 24. - P. 955-961.

17. Bosi E., Camisasca R.P., Collober C. et al. Effects of vildagliptin on glucose control over 24 weeks in patients with type 2 diabetes inadequately controlled with metformin // Diabetes Care. - 2007. - Vol. 30. - P. 890-895.

18. Ahren B., Pacini G., Foley J., Schweizer A. Improved meal-related betacell function and insulin sensitivity by the dipeptidyl peptidase-IV inhibitor vildagliptin in metformin-treated patients with type 2 diabetes over 1 year // Diabetes Care. -2005. - Vol. 28. - P. 1936-1940.

19. Ferrannini E., Fonseca V., Zinman B. et al. Fifty-two week efficacy and safety of vildagliptin vs. glimepiride in patients with type 2 diabetes mellitus inadequately controlled on metformin monotherapy // Diabetes Obes. Metab. - 2009. - Vol. 11(2). - P. 157-166.

20. Rosenstock J., Baron M.A., Dejager S. et al. Comparison of vildagliptin and rosiglitazone monotherapy in patients with type 2 diabetes. A 24-week, double-blind, randomized trial //Diabetes Care. - 2007. Vol. 30. - P. 217-223.

21. Azuma K., Radikova Z., Mancino J., et al. Measurements of islet function and glucose metabolism with the DPP-4 inhibitor vildagliptin in patients with type 2 diabetes // J. Clin. Endocrinol. Metab. - 2008. - Vol. 93. - P. 459-464.

22. Marfella R., Barbieri M. et al. Effects of vildagliptin twice daily versus sitagliptin once daily on 24-hour acute glucose fluctuations // J. Diab. Complicat. - 2009, in press.

23. Ligueros-Saylan M., Schweizer A., Dickinson S., Kothny W. Vildagliptin therapy is not associated with an increased risk of pancreatitis // EASD. Poster presentation. - 2009. - Р.

24. Foley J., Hoffmann P., Ligueros-Saylan M. et al. Lack of vildagliptin effects on the immune system // EASD. Poster presentation. - 2009. - P. 773.

25. Kothny W., Schweizer A., Dickinson S., Ligueros-Saylan M. Hepatic safety profile of vildagliptin, a new DPP-4 inhibitor for the treatment of type 2 diabetes // EASD. Poster presentation. - 2009. - P. 764.

26. Schweizer A., Dejager S., Shao Q. et al. Assessing cardio-vascular safety of vildagliptin // EASD. Poster Presentation. - 2009. - P. 763.


Review

For citations:


Khalimov Yu.Sh. Vildagliptin and its role in the treatment of diabetes mellitus. Diabetes mellitus. 2010;13(3):92-96. (In Russ.)

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ISSN 2072-0351 (Print)
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