tailieunhanh - Báo cáo y học: " Sitagliptin is effective and safe as add-on to insulin in patients with absolute insulin deficiency: a case series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Sitagliptin is effective and safe as add-on to insulin in patients with absolute insulin deficiency: a case series. | Kutoh Journal of Medical Case Reports 2011 5 117 http content 5 1 117 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Sitagliptin is effective and safe as add-on to insulin in patients with absolute insulin deficiency a case series Eiji Kutoh1 2 Abstract Introduction It is generally believed that incretin-based therapies are effective in patients possessing certain levels of preserved p-cell function. So far there are no reports that show the effectiveness of dipeptidyl peptidase-4 inhibitors in patients who absolutely lack the capacity for endogenous insulin secretion. Case presentation This report describes the efficacy of sitagliptin in three Japanese patients a 91-year-old Japanese woman with type 1 diabetes a 54-year-old Japanese man with type 2 diabetes and a 30-year-old Japanese man with features of both type 1 and type 2 diabetes who had no detectable post-meal C-peptide levels. Although they were receiving intensive insulin therapy together with some oral hypoglycemic agents their glycemic control remained poor. Sitagliptin was added to the ongoing therapeutic regimen to provide better glycemic control. Although these patients had mild hypoglycemia effective reductions of hemoglobin A1c levels were observed without any adverse events in the liver and kidney during the following 24 weeks. Two of the patients were able to reduce their insulin doses and one of the patients could discontinue one of the oral hypoglycemic agents. There was no weight gain or gastrointestinal complaints among the three patients. Postmeal C-peptide levels remained undetectable after sitagliptin treatment. Conclusion This report demonstrates that sitagliptin is effective and safe as an add-on therapy to insulin in reducing blood glucose levels in patients who absolutely lack the capacity for endogenous insulin secretion. The improvement seen in glycemic control could not be due to enhanced endogenous insulin secretion since postmeal C-peptide .

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