Singh Harmanjit, Chakrawarti Avinash, Singh Harjit, Guruprasad P, Gupta Yogendra Kumar
Department of Pharmacology, GMCH, Cahndigarh, India.
Department of Geriatric Medicine, All Institute of Medical Sciences, New Delhi, India.
J Family Med Prim Care. 2018 Jan-Feb;7(1):70-76. doi: 10.4103/jfmpc.jfmpc_89_17.
Dipeptidyl peptidase 4 (DPP4) inhibitors are attractive agents to be used in the elderly patients with Type 2 diabetes mellitus (T2DM) because of their beneficial effects.
In this cross-sectional, observational study, we evaluated and compared the treatment satisfaction using Diabetes Treatment Satisfaction Questionnaire (DTSQ) in two groups (i.e., regimens containing DPP4 inhibitors vs. other regimens). Efficacy was evaluated by assessing and comparing the glycosylated hemoglobin (HbA1c) values and the percentage of patients who achieved the glycemic control (HbA1c <7%). The adverse drug reactions (ADRs) were also recorded and compared among two groups.
A total of 115 patients participated in the study (42 in Group 1 and 73 in Group 2). Significantly better DTSQ scores were observed among Group 1 patients in terms of DTSQ score total ( = 0.01) and DTSQ score for perception of hyperglycemia ( = 0.008) as compared to Group 2 patients. Significant difference was observed in HbA1c values among two groups ( = 0.02, 95% confidence interval [CI], 0.06-1.14). Also, significantly higher proportion of patients had achieved glycemic control, i.e., HbA1c <7% in Group 1 as compared to Group 2 ( = 0.002, 95% CI, 11.8%-48.1%). Significantly higher number of ADRs were observed among Group 1 patients as compared to Group 2 ( = 0.003).
DPP4 inhibitors seem to offer better treatment satisfaction and efficacy in geriatric T2DM patients but at the expense of increased frequency of ADRs; however, further research is warranted.
由于具有有益作用，二肽基肽酶4（DPP4）抑制剂是用于老年2型糖尿病（T2DM）患者的有吸引力的药物。
在这项横断面观察性研究中，我们使用糖尿病治疗满意度问卷（DTSQ）评估并比较了两组（即含DPP4抑制剂的治疗方案与其他治疗方案）的治疗满意度。通过评估和比较糖化血红蛋白（HbA1c）值以及达到血糖控制（HbA1c<7%）的患者百分比来评估疗效。还记录并比较了两组之间的药物不良反应（ADR）。
共有115名患者参与研究（第1组42名，第2组73名）。与第2组患者相比，第1组患者在DTSQ总分（P=0.01）和高血糖感知的DTSQ评分（P=0.008）方面观察到明显更好的DTSQ评分。两组之间的HbA1c值存在显著差异（P=0.02，95%置信区间[CI]，0.06-1.14）。此外，与第2组相比（P=0.002，95%CI，11.8%-48.1%）第1组中达到血糖控制（即HbA1c<7%）的患者比例明显更高。与第2组相比，第1组患者中观察到的ADR数量明显更多（P=0.003）。
DPP4抑制剂似乎在老年T2DM患者中提供了更好的治疗满意度和疗效，但代价是ADR发生率增加；然而，有必要进行进一步研究。
