Assessment of Factors Affecting Therapeutic Response of the DPP-4 Inhibitor Sitagliptin in A Sample of Iraqi Type 2 Diabetic Patients

Authors

  • Ahmad Nazar Jawad Department of Clinical Pharmacy, College of Pharmacy, Mustansiriyah University
  • Kadhim Ali Kadhim Department of Clinical Pharmacy, College of Pharmacy, Mustansiriyah University, Baghdad, Iraq
  • Qusay Baqer Alzajaji Alhassan Metabolism, Endocrine and Diabetes center (HMEDC), Karbala, Iraq
  • Haider Al-Neshmi Griffith Base Hospital, NSW, Australia

DOI:

https://doi.org/10.32947/ajps.v24i3.1082

Keywords:

Type 2 diabetes, DPP-4 inhibitors, Sitagliptin

Abstract

Background: Type 2 diabetes is a complex and diverse disease, and the response to dipeptidyl peptidase-4 inhibitors may exhibit substantial variability between individuals. Several variables may play a role in variances in individual responses to treatment.

Objective: The purpose of the research was to assess the degree to which Iraqi patients with type 2 diabetes responded to sitagliptin and to investigate the factors that contribute to sitagliptin's overall efficacy.

Patients and methods: Eighty patients with type 2 diabetes who were using sitagliptin (100 mg per day) were included in this observational, cross-sectional study. Sociodemographic and patient clinical data were collected. Glycated hemoglobin (HbA1c), lipid profile parameters, and C-reactive protein were measured.

Results: The response rate to sitagliptin was 43.8%. Smokers and hypertensive patients, in addition to those not on diet, had higher HbA1c levels with nearly significant p values than non-smokers, normotensive patients, and those on diet, respectively. Poor response patients had higher levels of total cholesterol and triglycerides.

Conclusions: Possible variables that may have influenced the response to sitagliptin include smoking, hypertension, and an unhealthy diet. Furthermore, elevated levels of triglycerides may serve as an indicator of poor response.

References

- Hussein AHS, Kadhim KA, Fadil SM. Effect the Pharmaceutical Care and Health Education on Knowledge and Disease Control for Type 2 Diabetes Mellitus Patients: A sample of Iraqi Patients. Al Mustansiriyah Journal of Pharmaceutical Sciences 2020;20(1):40–54. DOI: https://doi.org/10.32947/ajps.v20i1.684

- Ahmed SM, Rashid BM, Kareim LMH, Abdulla SK, Salih JM, Nore BF. Association of Serum Homocysteine with Controlled and Uncontrolled Type2 Diabetes Mellitus in Sulaimani City. Al Mustansiriyah Journal of Pharmaceutical Sciences 2022;22(2):7–19. DOI: https://doi.org/10.32947/ajps.v22i2.834

- Tinajero MG, Malik VS. An Update on the Epidemiology of Type 2 Diabetes: A Global Perspective. Endocrinol Metab Clin North Am 2021;50(3):337–55. DOI: https://doi.org/10.1016/j.ecl.2021.05.013

- Mohammed HR, Kadhim KA, Alkutubi HM, Rahmah AM, Khalaf BH, Hussein SAR, et al. Correlation between ABO blood groups with insulin resistance in type ii diabetes mellitus patients using metformin. International Journal of Research in Pharmaceutical Sciences 2018;9(3):893–900.

- Reed J, Bain S, Kanamarlapudi V. A review of current trends with type 2 diabetes epidemiology, aetiology, pathogenesis, treatments and future perspectives. Diabetes Metab Syndr Obes 2021;3567–602. DOI: https://doi.org/10.2147/DMSO.S319895

- Iraq diabetes report 2000 — 2045 [Internet]. [cited 2023 Sep 2];Available from: https://diabetesatlas.org/data/en/country/96/iq.html

- DeMarsilis A, Reddy N, Boutari C, Filippaios A, Sternthal E, Katsiki N, et al. Pharmacotherapy of type 2 diabetes: An update and future directions. Metabolism 2022;137:1–23. DOI: https://doi.org/10.1016/j.metabol.2022.155332

- Florentin M, Kostapanos MS, Papazafiropoulou AK. Role of dipeptidyl peptidase 4 inhibitors in the new era of antidiabetic treatment. World J Diabetes 2022;13(2):85–92. DOI: https://doi.org/10.4239/wjd.v13.i2.85

- Rameshrad M, Razavi BM, Ferns GAA, Hosseinzadeh H. Pharmacology of dipeptidyl peptidase-4 inhibitors and its use in the management of metabolic syndrome: a comprehensive review on drug repositioning. DARU Journal of Pharmaceutical Sciences 2019;27(1):341–60. DOI: https://doi.org/10.1007/s40199-019-00238-7

- Liu D, Jin B, Chen W, Yun P. Dipeptidyl peptidase 4 (DPP-4) inhibitors and cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM): A systematic review and meta-analysis. BMC Pharmacol Toxicol 2019;20(1):1–9. DOI: https://doi.org/10.1186/s40360-019-0293-y

- Ahrén B. DPP-4 inhibition and the path to clinical proof. Front Endocrinol (Lausanne) 2019;10(376):1–18. DOI: https://doi.org/10.3389/fendo.2019.00376

- Saini K, Sharma S, Khan Y. DPP-4 inhibitors for treating T2DM - hype or hope? an analysis based on the current literature. Front Mol Biosci 2023;10(113):6–25. DOI: https://doi.org/10.3389/fmolb.2023.1130625

- Yin R, Xu Y, Wang X, Yang L, Zhao D. Role of Dipeptidyl Peptidase 4 Inhibitors in Antidiabetic Treatment. Molecules 2022, Vol 27, Page 3055 2022;27(10):1–17. DOI: https://doi.org/10.3390/molecules27103055

- Mamza J, Mehta R, Donnelly R, Idris I. Determinants of Glycemic Response to Add-On Therapy with a Dipeptidyl Peptidase-4 Inhibitor: A Retrospective Cohort Study Using a United Kingdom Primary Care Database. Diabetes Technol Ther 2016;18(2):85–92. DOI: https://doi.org/10.1089/dia.2015.0052

- Dennis JM, Shields BM, Hill A V., Knight BA, McDonald TJ, Rodgers LR, et al. Precision Medicine in Type 2 Diabetes: Clinical Markers of Insulin Resistance Are Associated With Altered Short- and Long-term Glycemic Response to DPP-4 Inhibitor Therapy. Diabetes Care 2018;41(4):705–12. DOI: https://doi.org/10.2337/dc17-1827

- Kadrić SI, Ćesić AK, Dujić T. Pharmacogenetics of new classes of antidiabetic drugs. Biomolecules and Biomedicine 2021;21(6):659–71.

- Kim SA, Shim WH, Lee EH, Lee YM, Beom SH, Kim ES, et al. Predictive Clinical Parameters for the Therapeutic Efficacy of Sitagliptin in Korean Type 2 Diabetes Mellitus. Diabetes Metab J 2011;35(2):159–65. DOI: https://doi.org/10.4093/dmj.2011.35.2.159

- Committee ADAPP. 6. Glycemic Targets: Standards of Medical Care in Diabetes—2022. Diabetes Care 2022;45(Supplement_1):S83–96. DOI: https://doi.org/10.2337/dc22-S006

- Mansour AA, Al-Maliky AA, Kasem B, Jabar A, Mosbeh KA. Prevalence of diagnosed and undiagnosed diabetes mellitus in adults aged 19 years and older in Basrah, Iraq. Diabetes, Metabolic Syndrome and Obesity 2014;7(2014):139–44. DOI: https://doi.org/10.2147/DMSO.S59652

- Wondmkun YT. Obesity, insulin resistance, and type 2 diabetes: Associations and therapeutic implications. Diabetes, Metabolic Syndrome and Obesity 2020;13(2020):3611–6. DOI: https://doi.org/10.2147/DMSO.S275898

- Petrie JR, Guzik TJ, Touyz RM. Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. Can J Cardiol 2018;34(5):575–84. DOI: https://doi.org/10.1016/j.cjca.2017.12.005

- Akalu Y, Belsti Y. Hypertension and Its Associated Factors Among Type 2 Diabetes Mellitus Patients at Debre Tabor General Hospital, Northwest Ethiopia. Diabetes Metab Syndr Obes 2020;13(2020):1621–31. DOI: https://doi.org/10.2147/DMSO.S254537

- Przezak A, Bielka W, Pawlik A. Hypertension and Type 2 Diabetes—The Novel Treatment Possibilities. Int J Mol Sci 2022;23(12):1–16. DOI: https://doi.org/10.3390/ijms23126500

- Akkuzulu H, Aypak C, Özdemir A, Görpelioǧlu S. Impact of smoking and nicotine addiction on HbA1c levels and diabetic microvascular complications. Clinical Diabetology 2020 ;9(2):112–7. DOI: https://doi.org/10.5603/DK.2020.0004

- Sari MI, Sari N, Darlan DM, Prasetya RJ. Cigarette Smoking and Hyperglycaemia in Diabetic Patients. Open Access Maced J Med Sci 2018;6(4):634–7. DOI: https://doi.org/10.3889/oamjms.2018.140

- Morimoto A, Tatsumi Y, Miyamatsu N, Sonoda N, Deura K. Association between smoking and post-load plasma glucose levels using a 75-g oral glucose tolerance test: the Saku Study. Diabetes Res Clin Pract 2014;106(2): e38–40. DOI: https://doi.org/10.1016/j.diabres.2014.08.013

- Jamaluddin JL, Huri HZ, Vethakkan SR. Clinical and genetic predictors of dipeptidyl peptidase-4 inhibitor treatment response in Type 2 diabetes mellitus. Pharmacogenomics 2016;17(8):867–81. DOI: https://doi.org/10.2217/pgs-2016-0010

- Wilson JR, Shuey MM, Brown NJ, Devin JK. Hypertension and Type 2 Diabetes Are Associated With Decreased Inhibition of Dipeptidyl Peptidase-4 by Sitagliptin. J Endocr Soc 2017;1(9):1168–78. DOI: https://doi.org/10.1210/js.2017-00312

- Hussain A, Ali I, Ijaz M, Rahim A. Correlation between hemoglobin A1c and serum lipid profile in Afghani patients with type 2 diabetes: hemoglobin A1c prognosticates dyslipidemia. Ther Adv Endocrinol Metab 2017;8(4):51–7. DOI: https://doi.org/10.1177/2042018817692296

- Hirano T. Pathophysiology of Diabetic Dyslipidemia. J Atheroscler Thromb 2018;25(9):771–82. DOI: https://doi.org/10.5551/jat.RV17023

- Matikainen N, Mänttäri S, Schweizer A, Ulvestad A, Mills D, Dunning BE, et al. Vildagliptin therapy reduces postprandial intestinal triglyceride-rich lipoprotein particles in patients with type 2 diabetes. Diabetologia 2006;49(9):2049–57. DOI: https://doi.org/10.1007/s00125-006-0340-2

- Shirakawa J, Fujii H, Ohnuma K, Sato K, Ito Y, Kaji M, et al. Diet-Induced Adipose Tissue Inflammation and Liver Steatosis Are Prevented by DPP-4 Inhibition in Diabetic Mice. Diabetes 2011;60(4):1246–57. DOI: https://doi.org/10.2337/db10-1338

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Published

2024-07-09

How to Cite

Assessment of Factors Affecting Therapeutic Response of the DPP-4 Inhibitor Sitagliptin in A Sample of Iraqi Type 2 Diabetic Patients. (2024). Al Mustansiriyah Journal of Pharmaceutical Sciences, 24(3), 311-319. https://doi.org/10.32947/ajps.v24i3.1082

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