Mitra Asis, Ray Saswati
Internal Medicine, Ruby General Hospital, Kolkata, IND.
Physiology, Jagannath Gupta Institute of Medical Science, Kolkata, IND.
Cureus. 2020 Jan 29;12(1):e6812. doi: 10.7759/cureus.6812.
Background and aim While diabetes mellitus (DM) is occupying the topmost global epidemic position, India is harboring a challenging number of type 2 DM patients in the world. This devastating picture of the health sector in India requires the availability of more cost-effective, context-specific, and safer drugs for DM management. This study aimed to evaluate the safety and efficacy of teneligliptin in Indian patients with type 2 DM inadequately controlled with diet, exercise, and a maximal dose of metformin treatment. Materials and methods This was a retrospective, observational, and single-center study conducted at a diabetic clinic in India in type 2 DM patients who have been treated with teneligliptin 40 mg once daily as add-on therapy with diet, exercise, and the maximal tolerable dose of metformin for three months. The study was observational, where the data collection was through self-reporting and an observational study conducted over one year (September 2018 to August 2019). A total of 100 patients were enrolled in the study (male 69% and female 31%). Patients with available data for fasting plasma glucose (FPG), postprandial plasma glucose (2h PPG), glycated hemoglobin (HbA1c), renal function parameters, such as urinary albumin to creatinine ratio (UACR), and electrocardiogram (ECG) at baseline and three months after treatment were enrolled in the study. Results There was a significant reduction in fasting blood sugar (P=<0.001), postprandial blood sugar (P=<0.001), and HbA1c (P=<0.001) at the end of the three months treatment in comparison to the baseline level and in the primary outcomes of this study as compared to baseline. The teneligliptin treatment did not cause any significant reduction in body mass index (BMI) before and after treatment. When we compared the secondary outcomes, the indicator of renal function as expressed through the albumin-to-creatinine ratio (ACR; P=0.052), there was a borderline change in ACR from baseline to three months. The mean corrected QT interval at screening baseline was 429.7 ± 8.89 milliseconds while after three months, it was 429.1 ± 8.68 milliseconds, which was statistically insignificant. Conclusion The current results demonstrated a high level of efficacy as an add-on therapy of teneligliptin at a high dose with inadequately controlled type 2 DM subjects in India. The study results also indicate the good tolerance of this drug with no critical adverse event in this study design.
背景与目的 虽然糖尿病(DM)在全球流行病中占据首位,但印度却拥有世界上数量惊人的2型糖尿病患者,这给治疗带来了挑战。印度卫生部门的这一严峻状况需要有更具成本效益、因地制宜且更安全的药物来管理糖尿病。本研究旨在评估替格列汀对饮食、运动及最大剂量二甲双胍治疗控制不佳的印度2型糖尿病患者的安全性和疗效。
材料与方法 这是一项在印度一家糖尿病诊所进行的回顾性、观察性单中心研究,研究对象为2型糖尿病患者,他们接受每日一次40毫克替格列汀作为饮食、运动及最大耐受剂量二甲双胍的附加治疗,为期三个月。该研究为观察性研究,数据收集通过自我报告以及为期一年(2018年9月至2019年8月)的观察性研究进行。共有100名患者纳入研究(男性占69%,女性占31%)。纳入研究的患者需在基线及治疗三个月后有空腹血糖(FPG)、餐后血糖(2小时PPG)、糖化血红蛋白(HbA1c)、肾功能参数如尿白蛋白肌酐比值(UACR)以及心电图(ECG)的可用数据。
结果 与基线水平相比,治疗三个月结束时空腹血糖(P<0.001)、餐后血糖(P<0.001)和HbA1c(P<0.001)均有显著降低,且在本研究的主要结局方面与基线相比也有显著降低。替格列汀治疗前后体重指数(BMI)无显著降低。在比较次要结局时,通过白蛋白肌酐比值(ACR)表示的肾功能指标(P=0.052),从基线到三个月时有临界变化。筛查基线时平均校正QT间期为429.7±8.89毫秒,三个月后为429.1±8.68毫秒,差异无统计学意义。
结论 目前的结果表明,在印度,高剂量替格列汀作为附加治疗对控制不佳的2型糖尿病患者具有高度疗效。研究结果还表明该药物耐受性良好,在本研究设计中未出现严重不良事件。