Effects of sitagliptin on counterregulatory and incretin hormones during acute hypoglycaemia in patients with type 1 diabetes: a randomized double blind placebo-controlled cross-over study

TY - JOUR

T1 - Effects of sitagliptin on counterregulatory and incretin hormones during acute hypoglycaemia in patients with type 1 diabetes

T2 - a randomized double blind placebo-controlled cross-over study

AU - Schopman, J E

AU - Hoekstra, J B L

AU - Frier, B M

AU - Ackermans, M T

AU - de Sonnaville, J J J

AU - Stades, A M

AU - Zwertbroek, R

AU - Hartmann, B

AU - Holst, Jens Juul

AU - Knop, F K

AU - Holleman, F

N1 - This article is protected by copyright. All rights reserved.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Aims: To assess whether the dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin affects glucagon and other counter-regulatory hormone responses to hypoglycaemia in patients with type 1 diabetes. Methods: We conducted a single-centre, randomized, double-blind, placebo-controlled, three-period crossover study. We studied 16 male patients with type 1 diabetes aged 18-52years, with a diabetes duration of 5-20years and intact hypoglycaemia awareness. Participants received sitagliptin (100mg/day) or placebo for 6weeks and attended the hospital for three acute hypoglycaemia studies (at baseline, after sitagliptin treatment and after placebo). The primary outcome was differences between the three hypoglycaemia study days with respect to plasma glucagon responses from the initialization phase of the hypoglycaemia intervention to 40min after onset of the autonomic reaction. Results: Sitagliptin treatment significantly increased active levels of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1. No significant differences were observed for glucagon or adrenergic counter-regulatory responses during the three hypoglycaemia studies. Growth hormone concentration at 40min after occurrence of autonomic reaction was significantly lower after sitagliptin treatment [median (IQR) 23 (0.2-211.0)mEq/l] compared with placebo [median (IQR) 90 (8.8-180)mEq/l; p=0.008]. Conclusions: Sitagliptin does not affect glucagon or adrenergic counter-regulatory responses in patients with type 1 diabetes, but attenuates the growth hormone response during late hypoglycaemia.

AB - Aims: To assess whether the dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin affects glucagon and other counter-regulatory hormone responses to hypoglycaemia in patients with type 1 diabetes. Methods: We conducted a single-centre, randomized, double-blind, placebo-controlled, three-period crossover study. We studied 16 male patients with type 1 diabetes aged 18-52years, with a diabetes duration of 5-20years and intact hypoglycaemia awareness. Participants received sitagliptin (100mg/day) or placebo for 6weeks and attended the hospital for three acute hypoglycaemia studies (at baseline, after sitagliptin treatment and after placebo). The primary outcome was differences between the three hypoglycaemia study days with respect to plasma glucagon responses from the initialization phase of the hypoglycaemia intervention to 40min after onset of the autonomic reaction. Results: Sitagliptin treatment significantly increased active levels of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1. No significant differences were observed for glucagon or adrenergic counter-regulatory responses during the three hypoglycaemia studies. Growth hormone concentration at 40min after occurrence of autonomic reaction was significantly lower after sitagliptin treatment [median (IQR) 23 (0.2-211.0)mEq/l] compared with placebo [median (IQR) 90 (8.8-180)mEq/l; p=0.008]. Conclusions: Sitagliptin does not affect glucagon or adrenergic counter-regulatory responses in patients with type 1 diabetes, but attenuates the growth hormone response during late hypoglycaemia.

U2 - 10.1111/dom.12453

DO - 10.1111/dom.12453

M3 - Journal article

C2 - 25694217

SN - 1462-8902

VL - 17

SP - 546

EP - 553

JO - Diabetes, Obesity and Metabolism

JF - Diabetes, Obesity and Metabolism

IS - 6

ER -