Thesis or Dissertation Efficacy of dipeptidyl peptidase-4 inhibitors in patients with glucocorticoid-induced diabetes assessed by continuous glucose monitoring

Yata, Yusuke  ,  矢田, 雄介

pp.1 - 24 , 2017-09-20 , 新潟大学
学位の種類: 博士(医学). 報告番号: 甲第4355号. 学位記番号: 新大院博(医)甲第768号. 学位授与年月日: 平成29年9月20日
The Assessment of the Efficacy of Dipeptidyl Peptidase-4 Inhibitors in Patients with Glucocorticoid-induced Diabetes by Continuous Glucose Monitoring. Internal Medicine. 2017, 56(19), 2555-2562.
Objective Administration of glucocorticoids usually causes a mild increase in fasting glucose levels and a greater dose-dependent increase in postprandial values in patients without pre-existing diabetes mellitus. Patients with persistent hyperglycemia due to glucocorticoid therapy sometimes require insulin therapy that may result in more weight gain and more episodes of hypoglycemia, some of which are severe. On the other hand, scant evidence is available on the efficacy of oral hypoglycemic agents for glucocorticoid-induced diabetes. In this study, we evaluated the efficacy of dipeptidyl peptidase (DPP)-4 inhibitors in patients with glucocorticoid-induced diabetes by continuous glucose monitoring (CGM). Methods We examined glycemic profiles using CGM at baseline and 1–4 weeks after initiating DPP-4 inhibitor treatment in patients with newly developed glucocorticoid-induced diabetes. Results Eleven patients diagnosed with kidney disease or other diseases with renal involvement were recruited for retrospective analysis in this study. After starting DPP-4 inhibitors, the mean and the SD of glucose levels, and the mean amplitude of glycemic excursion (MAGE) were significantly improved compared with baseline. Furthermore, the area over the curve for glucose levels <70 mg/dL was not increased compared with baseline after initiating DPP-4 inhibitors. Treatment of patients with glucocorticoid-induced diabetes using DPP-4 inhibitors can thus minimize the risk of hypoglycemia and reduce glucose variability. Conclusion DPP-4 inhibitors are potentially useful for blood glucose control in patients with glucocorticoid-induced diabetes.

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