Exercise and the dipeptidyl‐peptidase IV inhibitor sitagliptin do not improve beta‐cell function and glucose homeostasis in long‐lasting type 1 diabetes—A randomised open‐label study. Issue 3 (23rd May 2019)

• Record Type: Journal Article
• Authors: Seelig, Eleonora; Trinh, Beckey; Hanssen, Henner; Schmid‐Trucksäss, Arno; Ellingsgaard, Helga; Christ‐Crain, Mirjam; Donath, Marc Y.
• Is Part Of: Endocrinology, diabetes & metabolism. Volume 2:Issue 3(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-05-23
• Subjects: beta‐cell regeneration -- dipeptidyl‐peptidase IV inhibitor -- exercise -- glucagon‐like peptide‐1 -- interleukin 6 -- type 1 diabetes mellitus; Endocrinology -- Periodicals; Diabetes -- Periodicals; Metabolism -- Periodicals; 616.4
• DOI: 10.1002/edm2.75
• Languages: English
• ISSNs: 2398-9238

Abstract

Abstract: Background: Increasing evidence points to beta‐cell regeneration in individuals with type 1 diabetes mellitus (type 1 DM) at all stages of the disease. Exercise and glucagon‐like peptide‐1 (GLP‐1) independently improve beta‐cell function and glucose homeostasis in animal studies and in clinical trials in individuals with type 2 diabetes mellitus (type 2 DM). Whether a combination of both, exercise and GLP‐1, induces a similar effect in individuals with long‐lasting type 1 DM remains to be investigated. Methods: In an open‐label study, participants with long‐standing type 1 DM were randomly assigned to oral sitagliptin 100 mg daily for 12 weeks in combination with or without an exercise intervention. The primary end‐point was change in the area under the concentration‐time curve of C‐peptide during a mixed meal tolerance test before and after 12 weeks of intervention. Results: A total of 24 participants were included in the study and treated with sitagliptin, 12 participants were allocated to a 12‐week exercise intervention. After 12 weeks, there was no difference in the change of AUC C‐peptide between groups (exercise: 0 [−1424 to 1870], no exercise: 2091 [283‐17 434]; P = 0.09). HDL improved in the exercise intervention group compared to the group with sitagliptin only (exercise: 0.11 [−0.09 to 0.27]; no exercise: −0.18 [−0.24 to 0.01]; P = 0.04). AUC glucose was numerically slightly lower in the exercise intervention group but this did not translate into changes in HbA1c. Conclusion: The combination of exercise and sitagliptin had no effect on beta‐cell function in individuals with long‐lasting type 1 DM. Abstract : Increasing evidence suggests beta‐cell differentiation and regeneration throughout the course of type 1 diabetes mellitus (type 1 DM). Glucagon‐like peptide‐1 improves beta‐cell differentiation and regeneration in animal models of type 1 and type 2 diabetes mellitus, and its production from alpha cells is upregulated by interleukin‐6 release during physical exercise. However, in our randomised open‐label study, exercise in combination with the dipeptidyl‐peptidase IV inhibitor sitagliptin did not improve beta‐cell function in individuals with long‐lasting type 1 DM.