- •Saxagliptin effectively controls glucose levels without affecting the body weight.
- •Saxagliptin also improves patients’ insulin resistance and β-cell function.
- •Saxagliptin monotherapy can prevent or delay the progression of IGT or IFG to T2DM in obese patients.
- •Saxagliptin monotherapy is a credible alternative to metformin in obese pre-diabetic patients.
To assess the effect of saxagliptin monotherapy on blood glucose and islet β-cell function in obese patients with newly diagnosed pre-diabetes and abnormal fat metabolism.
A 24-week, randomized controlled trial was conducted involving 25 obese subjects with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) (mean age 45 years) to receive lifestyle intervention only (control group) or combined with saxagliptin 2.5 mg or 5 mg daily (S2.5 or S5 group), metformin 1500 mg daily (Met group). Anthropometrics, body fat and biochemical parameters were measured before and after 4, 12 and 24 weeks intervention.
S5 group and Met group showed a significant decrease in fasting plasma glucose (FPG) and HbA1c compared with the control group (all P < 0.05) after 24-week intervention. However, the decrease in 2 h postprandial plasma glucose levels (2 h PPG) in S5 group were greater compared with control group (P < 0.01). Insulin resistance (HOMA-IR) was reduced in S5 group, Met group and control group (P < 0.05), and the β-cell function (HOMA-β) was improved in all groups (P < 0.05). However, the changes in obesity-related indicators including waist circumference, hip circumference, weight, BMI, body fat, percentage of body fat and waist-to-hip fat ratio were greate in Met group (all P < 0.05) compared with other groups (P > 0.05).
Saxagliptin monotherapy may prevent or delay the progression of IGT or IFG to type 2 diabetes mellitus in obese patients with newly diagnosed pre-diabetes.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Diabetes Research and Clinical Practice
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Albuminuria: a target for treatment of type 2 diabetic nephropathy.Semin Nephrol. 2007; 27: 172-181
- Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group.JAMA. 1999; 281: 2005-2012
- Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating G. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants.Lancet. 2011; 378: 31-40
- China Noncommunicable Disease Surveillance G. Prevalence and control of diabetes in Chinese adults.JAMA. 2013; 310: 948-959
- Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention.Diabet Med. 2002; 19: 708-723
Diabetes mellitus. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1985;727:1–113.
- Diabetes-2016: Summary of Revisions.Diabetes Care. 2016; 39: S4-S5
- The rising prevalence of diabetes and impaired glucose tolerance: the Australian Diabetes, Obesity and Lifestyle Study.Diabetes Care. 2002; 25: 829-834
- Impact of incretin hormones on beta-cell function in subjects with normal or impaired glucose tolerance.Am J Physiol Endocrinol Metab. 2006; 291: E1144-E1150
- The dipeptidyl peptidase 4 inhibitor vildagliptin does not accentuate glibenclamide-induced hypoglycemia but reduces glucose-induced glucagon-like peptide 1 and gastric inhibitory polypeptide secretion.J Clin Endocrinol Metab. 2007; 92: 4165-4171
- The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes.Lancet. 2006; 368: 1696-1705
- The efficacy and safety of the dipeptidyl peptidase-4 inhibitor saxagliptin in treatment-naive patients with type 2 diabetes mellitus: a randomized controlled trial.Diabetol Metab Syndr. 2012; 4: 36
- Saxagliptin 014 Study G. The efficacy and safety of saxagliptin when added to metformin therapy in patients with inadequately controlled type 2 diabetes with metformin alone.Diabetes Care. 2009; 32: 1649-1655
- Sitagliptin 036 Study G. Effect of initial combination therapy with sitagliptin, a dipeptidyl peptidase-4 inhibitor, and metformin on glycemic control in patients with type 2 diabetes.Diabetes Care. 2007; 30: 1979-1987
- Effect of single oral doses of sitagliptin, a dipeptidyl peptidase-4 inhibitor, on incretin and plasma glucose levels after an oral glucose tolerance test in patients with type 2 diabetes.J Clin Endocrinol Metab. 2006; 91: 4612-4619
- American Diabetes A. Nutrition therapy recommendations for the management of adults with diabetes.Diabetes Care. 2013; 36: 3821-3842
- GADIA2-combi determination as first-line screening for improved prediction of type 1 diabetes in relatives.Diabetes. 1998; 47: 592-597
- Diabetes Care. 1997; 20: 1183-1197
- Homeostasis model assessment (HOMA) as surrogate insulinization criteria in patients with type 2 diabetes.Am J Ther. 2008; 15: 409-416
- Homeostasis model assessment is a reliable indicator of insulin resistance during follow-up of patients with type 2 diabetes.Diabetes Care. 2001; 24: 362-365
- Prediabetes: a high-risk state for diabetes development.Lancet. 2012; 379: 2279-2290
- Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes.N Engl J Med. 2013; 369: 145-154
N. U. Role of glucagon in the regulation of glucose homeostasis and the treatment of type 2 diabetes mellitus. Chinese Journal of Endocrinology and Metabolism 2010;9:836–839.
- (CD26)–role in the inactivation of regulatory peptides.Regul Pept. 1999; 85: 9-24
- Dipeptidyl peptidase-4 inhibitors for the treatment of type 2 diabetes mellitus.Pharmacotherapy. 2010; 30: 463-484
- Natural substrates of dipeptidyl peptidase IV.Adv Exp Med Biol. 2000; 477: 67-87
- Relationship between GLP-1 levels and dipeptidyl peptidase-4 activity in different glucose tolerance conditions.Diabet Med. 2010; 27: 691-695
- Northern Sweden Monitoring of T, Determinants in Cardiovascular D. Impaired incretin response after a mixed meal is associated with insulin resistance in nondiabetic men.Diabetes Care. 2001; 24: 1640-1645
- Management of type 2 diabetes mellitus in the elderly: special considerations.Drugs Aging. 2001; 18: 31-44
- Treatment of elderly patients with type 2 diabetes mellitus: a systematic review of the benefits and risks of dipeptidyl peptidase-4 inhibitors.Am J Geriatr Pharmacother. 2010; 8: 405-418
- Dipeptidyl peptidase-4 inhibitors in the elderly: more benefits or risks?.Adv Ther. 2012; 29: 218-233
- Sitagliptin: review of preclinical and clinical data regarding incidence of pancreatitis.Int J Clin Pract. 2010; 64: 984-990
- The safety and tolerability of GLP-1 receptor agonists in the treatment of type 2 diabetes: a review.Diabetes/Metab Res Rev. 2011; 27: 528-542
- Efficacy and safety of saxagliptin in drug-naive Asian patients with type 2 diabetes mellitus: a randomized controlled trial.Diabetes/Metabol Res Rev. 2012; 28: 268-275
- Efficacy and safety of saxagliptin added to metformin in Asian people with type 2 diabetes mellitus: a randomized controlled trial.Diabetes Res Clin Pract. 2011; 94: 217-224
- Sex differences in insulin resistance and cardiovascular disease risk.J Clin Endocrinol Metab. 2013; 98: E1716-E1721
- Effects of the dipeptidyl peptidase-IV inhibitor vildagliptin on incretin hormones, islet function, and postprandial glycemia in subjects with impaired glucose tolerance.Diabetes Care. 2008; 31: 30-35
- Vildagliptin, a dipeptidyl peptidase-IV inhibitor, improves model-assessed beta-cell function in patients with type 2 diabetes.J Clin Endocrinol Metab. 2005; 90: 4888-4894
- Current issues in the treatment of type 2 diabetes. Overview of newer agents: where treatment is going.Am J Med. 2010; 123: S38-48
Published online: May 12, 2017
Accepted: May 8, 2017
Received in revised form: April 21, 2017
Received: December 28, 2016
© 2017 Elsevier B.V. All rights reserved.