PMID- 22913902
OWN - NLM
STAT- MEDLINE
DCOM- 20121120
LR  - 20221207
IS  - 1941-9260 (Electronic)
IS  - 0032-5481 (Linking)
VI  - 124
IP  - 4
DP  - 2012 Jul
TI  - Use of dipeptidyl peptidase-4 inhibitors for the treatment of patients with type 
      2 diabetes mellitus and chronic kidney disease.
PG  - 138-44
LID - 10.3810/pgm.2012.07.2575 [doi]
AB  - Choices of antidiabetic agents for patients with type 2 diabetes mellitus (T2DM) 
      and chronic kidney disease (CKD) are limited. Available data suggest that the use 
      of dipeptidyl peptidase-4 (DPP-4) inhibitors may be safe in patients at various 
      stages of renal insufficiency. However, except for linagliptin, dosage adjustment 
      is necessary. The efficacy of DPP-4 inhibitors in patients with renal 
      insufficiency is generally similar to that of the general population with T2DM, 
      with reductions in mean glycated hemoglobin (HbA(1c)) levels of 0.7% to 1.0% 
      compared with baseline, and 0.4% to 0.7% compared with placebo. The frequency of 
      moderate hypoglycemia is 21% to 80% higher with DPP-4 inhibitors compared with 
      placebo, but the frequency of severe hypoglycemia is similar to that with 
      placebo. The use of DPP-4 inhibitors in patients with renal insufficiency is 
      associated with a slight weight loss of < 1 kg. Dipeptidyl peptidase-4 inhibitors 
      may be used as monotherapy in patients with CKD and HbA1c levels < 8.5% as an 
      alternative to insulin, glipizide, or pioglitazone. They can also be used as 
      add-on therapy to glipizide and/or pioglitazone in patients with HbA(1c) levels < 
      9%, but studies are needed to evaluate these combinations in patients with renal 
      insufficiency. Long-term and large-scale clinical trials are underway to better 
      determine the safety and efficacy of DPP-4 inhibitors in patients with T2DM with 
      and without CKD.
FAU - Mikhail, Nasser
AU  - Mikhail N
AD  - OliveView-UCLA Medical Center, Sylmar, CA 91342, USA. nmikhail@dhs.lacounty.gov
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Postgrad Med
JT  - Postgraduate medicine
JID - 0401147
RN  - 0 (Blood Glucose)
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Blood Glucose/drug effects
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Dipeptidyl-Peptidase IV Inhibitors/adverse effects/*therapeutic use
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects/*therapeutic use
MH  - Renal Insufficiency, Chronic/complications/*drug therapy
EDAT- 2012/08/24 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/08/24 06:00
PHST- 2012/08/24 06:00 [entrez]
PHST- 2012/08/24 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - 10.3810/pgm.2012.07.2575 [doi]
PST - ppublish
SO  - Postgrad Med. 2012 Jul;124(4):138-44. doi: 10.3810/pgm.2012.07.2575.