Sitagliptin, insulin combo better than insulin alone for treatment of LADA: Study

China: Sitagliptin plus insulin treatment improves insulin sensitivity and maintain β-cell function in latent autoimmune diabetes in adults (LADA) compared to insulin treatment alone, finds a recent study in the Journal of Clinical Endocrinology & Metabolism.

The long-term effects of dipeptidyl peptidase-4 inhibitors on insulin sensitivity and β-cell function in LADA is not clear. Zhiguang Zhou, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, and colleagues, therefore, aimed to investigate the effects of sitagliptin on β-cell function and insulin sensitivity in LADA patients receiving insulin.

For the purpose, the researchers performed a randomized controlled trial at the Second Xiangya Hospital. It included 51 LADA patients who were randomized to either sitagliptin + insulin group (SITA group) or insulin alone group (CONT group) for 24 months.

Fasting C-peptide (FCP), 2-hour postprandial C-peptide (2hCP) during mixed-meal tolerance test, △CP (2hCP - FCP) and updated homeostatic model assessment of β-cell function (HOMA2-B) were deterrmined every 6 months. Hyperglycemic clamp and hyperinsulinemic euglycemic clamp (HEC) tests were further conducted at 12-month intervals in 12 subjects. 

"Compared with insulin intervention alone, sitagliptin plus insulin treatment appeared to maintain β-cell function and improve insulin sensitivity in LADA to some extent," concluded the authors. 

The study titled, "Islet function and insulin sensitivity in latent autoimmune diabetes in adults taking sitagliptin: A randomized trial," is published in the Journal of Clinical Endocrinology & Metabolism.

DOI: https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgab026/6105049