DPP-4 inhibitors tied to low hypoglycemia risk in Inpatient diabetes patients: Study

Researchers combined the data from 3 randomized studies comparing DPP-4i alone or in combination with basal insulin or a basal-bolus insulin regimen. They included, Medicine (n = 266) and surgery (n = 319) patients admitted with blood glucose (BG) between 140 and 400 mg/dL, treated with diet, oral agents, or low-dose insulin therapy. They analyzed the patients who received DPP-4i alone (n = 144), DPP-4i plus basal insulin (n = 158) or basal-bolus regimen (n = 283). The major outcome assessed was the differences in mean daily BG between groups. They also assessed differences in hypoglycemia and hospital complications.

Key findings of the study were:

• Upon multivariate model adjusted for HbA1c, age, sex, and BMI, researchers found no difference in the percentage of BG readings within the target of 70 to 180 mg/dL (63 ± 32%, 60 ± 31%, and 64 ± 28% respectively).

• They also found no differences in mean hospital daily BG among patients treated with DPP-4i alone (170 ± 37 mg/dL), DPP-4i plus basal (172 ± 42 mg/dL), or basal-bolus (172 ± 43 mg/dL).

• They also noted no differences in length of stay or complications.

• However, they found that the hypoglycemia was less common with DPP-4i alone (2%) compared to DPP-4i plus basal (9%) and basal-bolus (10%).

The authors concluded, "Treatment with DPP-4i alone or in combination with basal insulin is effective and results in a lower incidence of hypoglycemia compared to a basal-bolus insulin regimen in general medicine and surgery patients with T2D".

For further information:

https://www.endocrinepractice.org/article/S1530-891X(20)36014-6/fulltext#%20