Open AccessDiabetes therapies in hemodialysis patients: Dipeptidase-4 inhibitors
Author(s) -
Yuya Nakamura,
Hitomi Hasegawa,
Mayumi Tsuji,
Yuko Udaka,
Makoto Mihara,
Tatsuo Shimizu,
Michiyasu Inoue,
Yoshikazu Goto,
Hiromichi Gotoh,
Masumi Inagaki,
Katsuji Oguchi
Publication year - 2015
Publication title -
world journal of diabetes
Language(s) - Uncategorized
Resource type - Journals
ISSN - 1948-9358
DOI - 10.4239/wjd.v6.i6.840
Subject(s) - medicine , vildagliptin , alogliptin , linagliptin , saxagliptin , diabetes mellitus , sitagliptin , hypoglycemia , pharmacology , dipeptidyl peptidase 4 , type 2 diabetes , endocrinology
Although several previous studies have been published on the effects of dipeptidase-4 (DPP-4) inhibitors in diabetic hemodialysis (HD) patients, the findings have yet to be reviewed comprehensively. Eyesight failure caused by diabetic retinopathy and aging-related dementia make multiple daily insulin injections difficult for HD patients. Therefore, we reviewed the effects of DPP-4 inhibitors with a focus on oral antidiabetic drugs as a new treatment strategy in HD patients with diabetes. The following 7 DPP-4 inhibitors are available worldwide: sitagliptin, vildagliptin, alogliptin, linagliptin, teneligliptin, anagliptin, and saxagliptin. All of these are administered once daily with dose adjustments in HD patients. Four types of oral antidiabetic drugs can be administered for combination oral therapy with DPP-4 inhibitors, including sulfonylureas, meglitinide, thiazolidinediones, and alpha-glucosidase inhibitor. Nine studies examined the antidiabetic effects in HD patients. Treatments decreased hemoglobin A1c and glycated albumin levels by 0.3% to 1.3% and 1.7% to 4.9%, respectively. The efficacy of DPP-4 inhibitor treatment is high among HD patients, and no patients exhibited significant severe adverse effects such as hypoglycemia and liver dysfunction. DPP-4 inhibitors are key drugs in new treatment strategies for HD patients with diabetes and with limited choices for diabetes treatment.