Skip to main content

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
Masashi Shimoda Masashi Shimoda 1*Yukino Katakura Yukino Katakura 1Akiko Mashiko Akiko Mashiko 1Masahiro Iwamoto Masahiro Iwamoto 2Shuhei Nakanishi Shuhei Nakanishi 1Takatoshi Anno Takatoshi Anno 1Fumiko Kawasaki Fumiko Kawasaki 1Atsushi Obata Atsushi Obata 1Yoshiro Fushimi Yoshiro Fushimi 1Junpei Sanada Junpei Sanada 1Kenji Kohara Kenji Kohara 1Hayato Isobe Hayato Isobe 1Yuichiro Iwamoto Yuichiro Iwamoto 1Hidenori Hirukawa Hidenori Hirukawa 1Fuminori Tatsumi Fuminori Tatsumi 1Yukiko Kimura Yukiko Kimura 1Tomohiko Kimura Tomohiko Kimura 1Tomoatsu Mune Tomoatsu Mune 1Kohei Kaku Kohei Kaku 1Hideaki Kaneto Hideaki Kaneto 1
  • 1 Kawasaki Medical School, Kurashiki, Japan
  • 2 Other, Zentsuji, Japan

The final, formatted version of the article will be published soon.

    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

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.