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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 |
doi: 10.3389/fendo.2024.1412553
Comparison of protective effects of DPP-4 inhibitor and SGLT2 inhibitor on pancreatic β-cell function: Randomized, parallel-group, multicenter, open-label study (SECRETE-I study)
Provisionally accepted- 1 Kawasaki Medical School, Kurashiki, Japan
- 2 Other, Zentsuji, Japan
The aim of this study is to directly compare the effects of SGLT2 inhibitors and DPP-4 inhibitors on β-cell function in patients with type 2 diabetes.We conducted a 26-week, randomized, open-label, parallel-group study, including a 1-2 week drug washout period, in patients with type 2 diabetes with HbA1c ≥7.0% and <9.0% and BMI ≥20 kg/m 2 despite treatment with a drug naïve or other than DPP-4 inhibitors or SGLT2 inhibitors. A total of 103 subjects were randomly assigned to receive once daily oral luseogliflozin (L) or teneligliptin (T). The primary endpoint was the effect of L vs. T on the change in log-transformed (Ln) disposition index (DI) (DI 0-120min; combining measures of insulin secretion and sensitivity) from baseline to week 25-26 (post intervention), which was calculated by conducting an oral glucose tolerance test.Results: Ln DI 0-120min were improved in both groups: -0.46±0.68 to -0.20±0.59 (p=0.03) in L group and -0.26±0.60 to -0.05±0.62 (p=0.01) in T group. The change in Ln serum proinsulin/CPR ratio, a marker of β-cell dysfunction, was reduced in L group (1.63±0.63 to 1.56±0.68, p=0.16), but rather increased in T group (1.70±0.75 to 1.90±0.51, p=0.01), with significant difference between the two groups (-0.27; p=0.004).Conclusions: Improvement of disposition index in subjects with obese type 2 diabetes was comparable between luseogliflozin and teneligliptin. On the other hand, it is likely that alleviation of β-cell dysfunction is more effective with luseogliflozin compared to tenegliptin.
Keywords: β-cell function, DPP-4 inhibitors, Proinsulin, SGLT2 inhibitors, Type 2 diabetes Trial registration Japan Registry of Clinical Trials jRCTs061190008 Abbreviations DPP4 Dipeptidyl peptidase-4 SGLT2 Sodium-glucose cotransporter 2
Received: 05 Apr 2024; Accepted: 05 Sep 2024.
Copyright: © 2024 Shimoda, Katakura, Mashiko, Iwamoto, Nakanishi, Anno, Kawasaki, Obata, Fushimi, Sanada, Kohara, Isobe, Iwamoto, Hirukawa, Tatsumi, Kimura, Kimura, Mune, Kaku and Kaneto. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Masashi Shimoda, Kawasaki Medical School, Kurashiki, Japan
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