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Aims/Introduction  The objective of the present study was to elucidate the effect of switching to teneligliptin from other dipeptidyl peptidase‐4 ( DPP ‐4) inhibitors on glucose control and renoprotection in type 2 diabetes mellitus patients with diabetic kidney disease.    Materials and Methods  The present study was a single‐arm, open‐label, observational study. A total of 23 patients, who had urinary albumin/creatinine ratios ( UACR ) ≥30 mg/ gC r in their first urine in the early morning, and received other  DPP ‐4 inhibitors and renin‐angiotensin system inhibitors, switched to teneligliptin 20 mg/day. After switching to teneligliptin for 24 weeks, we evaluated changes in glycated hemoglobin (HbA1c), fasting plasma glucose levels, plasma  DPP ‐4 activity and  UACR .    Results  HbA1c, fasting plasma glucose and  UACR  values showed no significant change after 24 weeks compared with baseline. However, plasma  DPP ‐4 activity was significantly reduced after 24 weeks (0.57 ± 0.26 nmol/min/ mL ,  P  =   0.012, vs baseline), compared with baseline (1.49 ± 1.73 nmol/min/ mL ), and there was a positive relationship between the change rate of plasma  DPP ‐4 activity (Δ% DPP ‐4) for 24 weeks and the levels of plasma  DPP ‐4 activity ( r  =   −0.5997,  P  =   0.0025) and fasting plasma glucose ( r  =   −0.4235,  P  =   0.0440) at baseline. Additionally, the Δ% DPP ‐4 for 24 weeks was significantly correlated to the change rate of  UACR  ( r  =   0.556,  P  =   0.0059). However, there was no relationship between Δ% DPP ‐4 and ΔHbA1c (amount of HbA1c change).    Conclusions  Switching to teneligliptin from other  DPP ‐4 inhibitors for 24 weeks reduces plasma  DPP ‐4 activity, which is associated with a reduction in albuminuria, independent of the change in glucose levels, in type 2 diabetes mellitus patients with diabetic kidney disease.

journal of diabetes investigation

Effect of switching to teneligliptin from other dipeptidyl peptidase‐4 inhibitors on glucose control and renoprotection in type 2 diabetes patients with diabetic kidney disease