The effects of dipeptidyl peptidase-4 inhibitors on fastingthickness blood glucose, HbA1C, creatin, ALT, amylase and lipase values in diagnosed with type 2 diabetes mellitus

Introduction and Aim: Diabetes mellitus is a chronic metabolic disease with systemic effects. DPP-4 inhibitors are oral antidiabetic agents that lower HbA1c moderately. DPP-4 inhibitors have been reported to increase pancreatitis risk. We aimed to investigate and compare the efficacy(fasting-postprandial blood glucose, HbA1C) and safety (serum creatinine, alt, amylase, lipase) of DPP-4 inhibitors(sitagliptin, vildagliptin, saxagliptin) which are in clinical use in our country. Materıal and Method: 87 type 2 DM patients were admitted to Gaziantep University Endocrinology and Metabolic Diseases Policlinic were enrolled into the study. The patients were divided into 3 groups according to the use of saxagliptin, sitagliptin and vildagliptin. Fasting and postprandial blood glucose, HbA1c, serum creatinine, ALT, amylase and lipase levels were recorded and compared at the beginning of the treatment and at the end of the 3rd month. Findings: There were no significant differences between the groups in terms of age and gender. Of the 87 type 2 diabetic patients, 30 used sitagliptin, 30 used vildagliptin, and 27 used saxagliptin. There was a significant decrease in APG and HbA1c values in the 3 groups at the end of the study. There was a significant decrease with vildagliptin and saxagliptin (p <0.05) but not with sitagliptin in postprandial glucose levels (p> 0.05). Serum creatinine levels were not significantly different but serum ALT values were significantly increased in saxagliptin group (p <0.05). Serum amylase and lipase values increased with all three DPP-4 inhibitor but there was a significance only with sitagliptin (p <0.05). Conclusion: In our study, slight elevation of amylase and lipase was detected in Type 2 DM patients using DPP-4 inhibitors. This increase was statistically significant in the sitagliptin group. DPP-4 inhibitors should be used with caution in patients at risk for pancreatitis and pancreatic cancer. Patients using DPP-4 inhibitors, especially sitagliptin, should be evaluated and monitored for pancreatitis risk factors. A large number of prospective studies to evaluate the safety of DPP-4 inhibitors on the pancreas will be helpful.