Sitagliptin ideal candidate to achieve better blood sugar control in elderly with diabetes

Sitagliptin has been suggested as a treatment option for older adults with type 2 diabetes (T2D) for controlling Blood sugar . However, no randomized controlled trial has been performed to evaluate the efficacy and safety of sitagliptin treatment in older Japanese patients with T2D. 

Researchers have found in a multicenter, open-label, randomized controlled trial   that sitagliptin improves the glycemic profile and is safe to use in elderly with type 2 diabetes.

The findings of STREAM study have been published in Nature Scientific Reports.

Sitagliptin is a medication that is used to treat type 2 diabetes. It works by increasing the levels of a hormone called glucagon-like peptide-1 (GLP-1) in the body. GLP-1 helps to stimulate the pancreas to produce more insulin, which can lower blood sugar levels. It also helps to slow down the absorption of sugar in the intestines, which can also help to lower blood sugar levels.

The STREAM study was a randomized controlled trial that aimed to evaluate the effects of sitagliptin treatment in T2D patients aged 65 to 80 years. The study included 176 patients with moderately controlled glycemic levels (HbA1c levels between 7.4% and 10.4%) who were not currently taking DPP4 inhibitors or GLP-1 receptor agonists. The patients were randomly assigned to either the sitagliptin group (n=88) or the control group (n=88). The sitagliptin group received sitagliptin as an initial or additional treatment, while the control group received no treatment. The goal of the study was to lower HbA1c levels to below 7.4%.

The results of the study were:

The sitagliptin group had significantly greater reductions in fasting plasma glucose, HbA1c, and glycated albumin levels compared to the control group.

Specifically, there were reductions of 27.2 mg/dL, 0.61%, and 2.39% in the sitagliptin group, and 0.50 mg/dL, 0.29%, and 0.93% in the control group, respectively.

There were no significant differences in the incidence of adverse effects between the two groups, with the exception of an increase in cystatin C levels and a decrease in platelet count in the sitagliptin group.

Reference:

Nagao, M., Sasaki, J., Sugihara, H., Tanimura-Inagaki, K., Harada, T., Sakuma, I., Oikawa, S., Asano, T., Aoyama, S., Fukushima, T., Yan, J., Hasegawa, O., Hosokawa, K., Ishimaru, Y., Kaito, H., Kanbara, R., Kanno, K., Kimura, K., … Moritani, S. (2023). Efficacy and safety of sitagliptin treatment in older adults with moderately controlled type 2 diabetes: the STREAM study. In Scientific Reports (Vol. 13, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1038/s41598-022-27301-9