Diabetes therapies in hemodialysis patients: Dipeptidase-4 inhibitors

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Yuya Nakamura1, Hitomi Hasegawa1, Mayumi Tsuji1

  • 1Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.

World Journal of Diabetes
|July 2, 2015
PubMed

Insights

Dipeptidyl peptidase-4 (DPP-4) inhibitors offer an effective oral treatment for diabetic hemodialysis patients, improving glycemic control without severe side effects. This review highlights their role in simplifying diabetes management for this population.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetic retinopathy and dementia complicate insulin management in hemodialysis (HD) patients.
  • Limited oral antidiabetic options exist for HD patients.
  • Dipeptidyl peptidase-4 (DPP-4) inhibitors present a novel therapeutic strategy.

Purpose of the Study:

  • To comprehensively review the efficacy and safety of DPP-4 inhibitors in diabetic HD patients.
  • To evaluate DPP-4 inhibitors as a new oral antidiabetic treatment strategy.

Main Methods:

  • Systematic review of nine studies on DPP-4 inhibitors in HD patients.
  • Analysis of available DPP-4 inhibitors (sitagliptin, vildagliptin, alogliptin, linagliptin, teneligliptin, anagliptin, saxagliptin) and combination therapies.

Main Results:

  • DPP-4 inhibitors, administered once daily with dose adjustments, effectively lowered hemoglobin A1c (0.3-1.3%) and glycated albumin (1.7-4.9%).
  • No significant severe adverse events like hypoglycemia or liver dysfunction were reported.
  • Combination therapy with sulfonylureas, meglitinides, thiazolidinediones, and alpha-glucosidase inhibitors is feasible.

Conclusions:

  • DPP-4 inhibitors demonstrate high efficacy and safety in diabetic HD patients.
  • These agents are crucial for managing diabetes in HD patients with limited treatment choices.
  • DPP-4 inhibitors simplify treatment regimens, addressing challenges posed by visual and cognitive impairments.

Keywords:
Anti-inflammatory effectsBlood glucose-related factorsDiabetes mellitusDipeptidase-4 inhibitorsHemodialysis

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