Management of a Prediabetes Case With the DPP-4 Inhibitor Sitagliptin. (June 2014)

• Record Type: Journal Article
• Authors: Johnson, Jeremy L.; O'Neal, Katherine S.; Pack, Christopher C.; Kim, Minhye K.
• Is Part Of: Annals of pharmacotherapy. Volume 48:Number 6(2014:Jun.)
• Page Start: 811
• Page End: 815
• Publication Date: 2014-06
• Subjects: prediabetes -- type 2 diabetes -- DPP-4 inhibitor -- sitagliptin -- β-cell; Chemotherapy -- Periodicals; Pharmacology -- Periodicals; 615.5805
• DOI: 10.1177/1060028014528681
• Languages: English
• ISSNs: 1060-0280

Abstract

Objective: It is important to prevent or slow the progression of prediabetes to type 2 diabetes and, therefore, reduce the risk of long-term complications. New therapeutic options will allow more patients to be effectively managed. Although theorized to be effective for prediabetes, dipeptidyl peptidase-4 (DPP-4) inhibitors have not been studied in this population. The purpose of this article is to report the results of a case in which a patient with prediabetes was treated with the DPP-4 inhibitor, sitagliptin.Case Summary: A 56-year-old woman was diagnosed with prediabetes at a hemoglobin A1C (A1C) of 6.2%. After 6 months of consistent lifestyle modifications, her A1C was 6.3%, and she wanted to start a medication to prevent disease progression. Because of anticipated risk or intolerability with standard prediabetes treatments, she was started on sitagliptin 100 mg daily; 6 weeks later, she noted improvements in glucometer readings. After 18 months on sitagliptin, her A1C had improved to 5.8% without further lifestyle improvements, and by 32 months, her A1C had improved to 5.6%. Her A1C was maintained within or below the prediabetes range of 5.7% to 6.4% over 3 years of treatment with sitagliptin.Discussion: Although human studies with DPP-4 inhibitors are lacking, the available studies have shown improvements in β-cell function and postprandial and fasting glucose levels. Furthermore, animal studies have shown a delay in progression of prediabetes. No case reports have been found regarding DPP-4 inhibitor use in prediabetes.Conclusion: Sitagliptin may have a role in treating prediabetes and should be further studied.