Reduction in the Risk of Peripheral Neuropathy and Lower Decrease in Kidney Function with Metformin, Linagliptin or...

Area of Science:

• Endocrinology
• Nephrology
• Neurology

Background:

• Prediabetes is a growing public health concern associated with increased risk of cardiovascular disease and organ damage.
• Peripheral nerve and kidney complications are common in prediabetes, necessitating effective interventions.

Purpose of the Study:

• To investigate the comparative effects of metformin, linagliptin, and their combination on peripheral nerve and kidney function in adults with prediabetes.

Main Methods:

• A multicenter, randomized, placebo-controlled trial involving 658 adults with prediabetes.
• Participants received metformin, linagliptin, a combination, or placebo for one year.
• Primary endpoints included small fiber peripheral neuropathy (SFPN) risk and estimated glomerular filtration rate (eGFR).

Main Results:

• Metformin, linagliptin, and their combination significantly reduced SFPN risk compared to placebo (25.1%, 17.3%, and 19.5% reduction, respectively).
• The combination therapy showed a trend towards preserving eGFR, with a statistically significant increase of +3.3 mL/min compared to placebo.
• Fasting plasma glucose and body weight were significantly reduced with metformin monotherapy and combination therapy.

Conclusions:

• One-year treatment with metformin and linagliptin, alone or in combination, is associated with a reduced risk of SFPN in individuals with prediabetes.
• These glucose-lowering therapies may also help preserve kidney function, as indicated by a lower decrease in eGFR compared to placebo.