Sitagliptin may not control blood sugar during bypass surgery in diabetics: Study
USA: Perioperative administration of sitagliptin in diabetes patients undergoing bypass surgery does not prevent hyperglycemia or complications, finds a recent study in the journal Diabetes, Obesity and Metabolism. The sitagliptin therapy, however, reduced daily insulin requirements when the patient shifted to regular ward.
Guillermo E Umpierrez, Department of Medicine, Emory University, Atlanta, Georgia, and colleagues assessed whether sitagliptin treatment before surgery and during the hospital stay can help in preventing and reducing the severity of perioperative hyperglycemia in type 2 diabetes (T2D) patients undergoing coronary artery bypass graft (CABG) surgery.
For the purpose, the researchers conducted a double‐blinded, placebo‐controlled trial in 182 adults with T2D. They were randomly assigned to receive sitagliptin (n=91) or matching placebo (n=91) starting 1 day prior to surgery and continued during the hospital stay.
The primary outcome was difference in the proportion of patients with postoperative hyperglycaemia (blood glucose [BG] > 10 mmol/L [>180 mg/dL]) in the intensive care unit (ICU). Secondary endpoints included differences in mean daily BG in the ICU and after transition to regular wards, hypoglycaemia, hospital complications, length of stay and need of insulin therapy.
Key findings of the study include:
- There were no differences in the number of patients with postoperative BG greater than 10 mmol/L, mean daily BG in the ICU or after transition to regular wards, hypoglycaemia, hospital complications or length of stay.
- There were no differences in insulin requirements in the ICU; however, sitagliptin therapy was associated with lower mean daily insulin requirements (21.1 ± 18.4 vs. 32.5 ± 26.3 units) after transition to a regular ward compared with placebo.
"Our findings indicate that the use of sitagliptin, prior to surgery and continued during hospital stay, did not reduce the frequency of perioperative hyperglycaemia or hospital complications in patients with type 2 diabetes after cardiac surgery," concluded the authors.
"Sitagliptin for the prevention and treatment of perioperative hyperglycaemia in patients with type 2 diabetes undergoing cardiac surgery: A randomized controlled trial," is published in the journal Diabetes, Obesity and Metabolism.
DOI: https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14241
