Efficacious and safe management of type 2 diabetes mellitus using DPP-4 inhibitors
https://doi.org/10.14341/2072-0351-5677
Abstract
Diabetes mellitus (DM) is believed to be the third most frequent direct cause of death after cardiovascular and oncological diseases. Therefore, solutionof DM-related problems is a major challenge facing health authorities in many countries. No doubt, strict control of glycemia is an indispensablecondition for the reduction of the frequency of diabetic complications. Indeed, many strategies developed in the recent years allowed metabolic controlin DM patients to be significantly improved. Basic and clinical research of the last decade provided a basis for the development of highly promisingtrends in the treatment of CD2, such as the use of incretins. Inhibitors of dipeptylpeptidase-4 (DPP-4) including Galvus (vildagliptin) and GalvusMet (vildagliptin + metformin) have been available in this country for the last 2 years. International studies showed high efficiency and safety of bothagents. They help to achieve adequate glycemic control in the absence of side effects and complications. Galvus significantly reduces daily variabilityof glycemia that is known to be a risk factor of severe vascular complications of DM. Another advantage of these drugs is they can be used by agedpatients at risk of cardiovascular disorders suffering hypertension. An example of combined therapy using Galvus Met in a DM2 patient is presenteddemonstrating markedly improved glycemic control, blood glucose dynamics, and quality of life. Galvus and Galvus Met can be prescribed as aninitial treatment in combination with all traditional oral hypoglycemic agents and insulin.
About the Authors
Alexander Sergeevich Ametov
Russian Medical Academy of Post-Diploma Education, Moscow
Ekaterina Vladimirovna Karpova
Russian Medical Academy of Post-Diploma Education, Moscow
References
1. Kannel W.B., Mc Gee D.L. Diabetes and cardiovascular diseases: the Framingham Study // JAMA. - 1979. - 241. - Р. 2035-2038.
2. Laakso L., Lehto S. Epidemiology of macrovascular disease in diabetes // Diabetes Rev. - 1997. - 5. - Р. 294-315.
3. Eastman R.C., Javitt J.C., Herman W.H., Dasbach E.J., Zbrozek A.S., Dong F., Manninen D., Gardfield S.A., Copley-Merriman C., Maier W., Eastman J.F., Kotsanos J., Cowie C.C., Harris M. Model of complications of NIDDM 1: Model constructions and assumptions // Diabetes Care. - 1997. - 20. - Р. 725-734.
4. Gaede P., Vedel P., Larsen N., Jensen G.V.H., Parving H.H., Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes // N. Engl. J. Med. - 2003. - 348. - Р. 383-393.
5. DCCT Research Group: The relationship of a glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the Diabetes Control and Complications Trial. Diabetes. - 1995. - 44. - Р. 968-983.
6. Klein R. Hyperglycemia and microvascular disease in diabetes // Diabetes Care. - 1995. - 18. - Р. 258-268.
7. Stratton I.M., Adler A.I., Neil H.A., Matthews D.R., Manley S.E., Cull C.A., Hadden D., Turner R.C., Holman R.R. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study // BMJ. - 2000. - 321. - Р. 405-412.
8. Brownlee M. Biochemistry and molecular cell biology of diabetic complications // Nature. - 2001. - 414. - Р. 813-820.
9. Brownlee M. Banting lecture 2004. The pathobiology of diabetic complications: a unifying mechanism // Diabetes. - 2005. - 54. - Р. 1615-1625.
10. Bonora E., Calcaterra F., Lombardi S., Bonfante N., Formentini G., Bonadonna R.C., Muggeo M. Plasma Glucose Levels Throughout the Day and HbA1c Interrelationships in Type 2 Diabetes // Diabetes Care. - 2001. - Vol. 24. - P. 2023-2029.
11. Fonseca V., Dejager S., Albrecht S. et al. Vildagliptin as add-on to insulin in patients with type 2 diabetes (T2DM) // Diabetes. - 2006. - 55(suppl 1). - P. A111.
12. Derr R., Garrett E., Stacy G.A., Saudek C.D. Is HbA1c affected by Glycemic Instability? // Diabetes Care. - 2003. - Vol. 26. - P. 2728-2733.
13. Monnier L., Lapinski H., Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients // Diabetes Care. - 2003. - Vol. 26. - P. 881-885.
14. Funatsu H., Yamashita H., Ohashi Y. Effect of rapid glicaemic control on progression of diabetic retinopathy // Jpn. J. Ophthalmol. - 1992. - Vol. 36. - № 3. - P. 356-367.
15. Boland E., Monsod T., Delucia M., Bonfante N., Formentini G., Bonadonna R.C., Muggeo M. Limitations of conventional methods of self-monitoring of blood glucose: lessons learned from 3 days of continuous glucose sensing in pediatric patients with type 1 diabetes // Diabetes Care. - 2001. - Vol. 24. - P. 1858-1862.
16. Bode B., Schwartz S., Stubbs H. et al. Glycemic Characteristics in Continuously Monitored Patients with type 1 and type 2 diabetes // Diabetes Care. - 2005. - Vol. 26. - № 10. - P. 2361-2366.
17. King H., Aubert R.E., Herman W.H. Global burden of diabetes, 1995- 2025: prevalence, numerical estimates, and projections // Diabetes Care. - 1998. - Р. 1414-1431.
18. Schweizer A., Couturier A., Foley J.E. and Dejager. S. Comparison between vildagliptin and metformin to sustain reductions in HbA1c over 1 year in drug-naпve patients with Type 2 diabetes // Diabet. Med. - 2007. - 24. - P. 955-961.
19. Rosenstock J., Baron M.A., Dejager S., Mills D., Schweizer A. Comparison of vildagliptin and rosiglitazone monotherapy in patients with type 2 diabetes: a 24-week, double-blind, randomized trial // Diabetes Care. - 2007. - 30. - P. 217-23.
20. Halimi S., Schweizer A., Minic B., Foley J., Dejager S. Combination treatment in the management of type 2 diabetes: focus on vildagliptin and metformin as a single tablet // Vascular. Health. and Risk Management. - 2008. - 4(3). - Р. 481-492.
21. Ferrannini E et al. 52-week efficacy and safety of vildagliptin versus glimepiride in patients with type 2 diabetes mellitus inadequately controlled on metformin monotherapy // Diabetes, Obesity and Metabolism. - 2009. - 11. - P. 157-166.
22. Ahrem B., Foley J. Improved Meal-Related -Cell Function and Insulin Sensitivity by the Dipeptidyl Peptidase-IV Inhibitor Vildagliptin in Metformin- Treated Patients With Type 2 Diabetes Over 1Year // Diabetes Care. - 2005. - 28. - P. 1936-1940.
23. Marfella R., Barbieri M., Grella .R, Rizzo M.R., Nicoletti G.F., Paolisso G. Effects of vildagliptin twice daily versus sitagliptin once daily on 24-hour acute glucose fluctuations // J. Diabetes Complications. - 2010. - Mar- Apr; 24(2). - P. 79-83.
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For citations:
Ametov A.S., Karpova E.V. Efficacious and safe management of type 2 diabetes mellitus using DPP-4 inhibitors. Diabetes mellitus. 2010;13(2):69-75. (In Russ.) https://doi.org/10.14341/2072-0351-5677
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