Clinical audit of patients using DPP4 inhibitors in longstanding type 2 diabetes

Dipeptidyl peptidase-4 inhibitors (DPP 4i) are oral hypoglycemic agents and are supposed to be beneficial in the early stages of diabetes. In this study, we evaluated the role of DPP4i in long standing type 2 diabetes mellitus (T2DM).

This retrospective data analysis was conducted from the patient records. All the patients (T2DM>5 years; Age>50 years; Gliptin use >12 months) were divided into 2 groups based on the duration of T2DM: Group A (<10 years) and Group B (>10 years). We excluded patients with type 1 diabetes and drug default of more than one month. Our primary objective was to study the change in HbA1c and secondary objectives were change in body weight and insulin requirement. Data are presented as mean ± S.D and comparison between the groups was done using Mann-Whitney and Fisher's exact tests.

The study participants (n=501) had a mean age (64.2 ± 8.2 yr), diabetes duration (10.1 ± 4.9 yr), body weight (65.3 ± 9.5 kg), BMI (23.4 ± 3.9 kg/m(2)) and HbA1c of 9.7 ± 1.3%. The use of gliptins resulted in similar HbA1c reduction between the groups (p=0.8405) and greater reduction of insulin requirement in group B (p=0.0433) at the end of one year. Body weight and hypoglycemia episodes did not differ between the groups.

DPP4 inhibitors give similar benefit irrespective of the duration of diabetes and our data gives reassurance about their role in long standing diabetes.