The DPP-4 inhibitor sitagliptin improves glycaemic control and early-stage diabetic nephropathy in adolescents with type 1 diabetes using the MiniMed 780G advanced hybrid closed-loop system: a randomised controlled trial
Authors' conclusion
Sitagliptin as an add-on therapy to AHCL had a reno-protective effect for individuals with type 1 diabetes and diabetic nephropathy, in addition to the improvement of time in range while reducing glycaemic variability and without compromising safety.
Study context
- Population
- Adolescents (aged 14.13 ± 2.43 years) with T1D on MiniMed 780G system ≥6 months, HbA1c ≤69 mmol/mol (8.5%) and diabetic nephropathy (microalbuminuria), Ain Shams University, Egyptall analysed
- Participants
- 46 adolescents
- Comparison
- Sitagliptin add-on to advanced hybrid closed-loop (AHCL) vs AHCL only
- Sitagliptinn = 23
- Controln = 23reference
- Primary endpoint
- Change in urinary albumin/creatinine ratio (UACR)
- Follow-up
- 3 months
Methodological detailsopen-label, parallel-group, single-centre
- Open-label
- Parallel-group
- Single-centre
Primary result
As reported in the abstract
UACR in the sitagliptin group, baseline to 3 months
- Urinary albumin/creatinine ratio (UACR) improved with sitagliptin from 7.27 ± 2.41 to 1.32 ± 0.31 mg/mmol
- p<0.001
Secondary outcomes
Key secondary: SDF-1 levels in the sitagliptin group, baseline to 3 months
- Significant decrease of SDF-1 with sitagliptin from 3.58 ± 0.73 to 1.99 ± 0.76 ng/ml
- P < 0.001
Glycaemic and insulin measures
- Sitagliptin reduced postprandial glucose, sensor glucose, CV and total daily insulin dose; TIR 3.9-10.0 mmol/l (70-180 mg/dl) and insulin-to-carbohydrate ratio significantly increased
Serum SDF-1, T1D vs healthy controls
- Serum SDF-1 higher in all individuals with T1D vs healthy controls
- P < 0.001
Safety
- Sitagliptin safe and well tolerated, without severe hypoglycaemia or DKA
Original publication
The DPP-4 inhibitor sitagliptin improves glycaemic control and early-stage diabetic nephropathy in adolescents with type 1 diabetes using the MiniMed 780G advanced hybrid closed-loop system: a randomised controlled trial. Diabetologia. Published 14 September 2024. doi:10.
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