Basal-Supported Oral Therapy with Sitagliptin Counteracts Rebound Hyperglycemia Caused by GLP-1 Tachyphylaxis
Introduction. Treatment with a glucagon-like peptide 1 (GLP-1) analog fails in some patients due to rebound hyperglycemia caused by tachyphylaxis (GLP-1 tachyphylaxis). We investigated the efficacy of basal-supported oral therapy (BOT) with insulin glargine and sitagliptin for counteracting GLP-1 ta...
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2014-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2014/927317 |
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| author | Shu Meguro Toshihide Kawai Tomohiro Matsuhashi Motoaki Sano Keiichi Fukuda Hiroshi Itoh Yoshihiko Suzuki |
| author_facet | Shu Meguro Toshihide Kawai Tomohiro Matsuhashi Motoaki Sano Keiichi Fukuda Hiroshi Itoh Yoshihiko Suzuki |
| author_sort | Shu Meguro |
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| description | Introduction. Treatment with a glucagon-like peptide 1 (GLP-1) analog fails in some patients due to rebound hyperglycemia caused by tachyphylaxis (GLP-1 tachyphylaxis). We investigated the efficacy of basal-supported oral therapy (BOT) with insulin glargine and sitagliptin for counteracting GLP-1 tachyphylaxis. Materials and Methods. The subjects were 12 men and 3 women aged 59.9±10.0 years who had been treated with GLP-1 analogs. All of them had developed rebound hyperglycemia caused by GLP-1 tachyphylaxis. Their GLP-1 analog-based therapy was switched to BOT with insulin glargine plus sitagliptin and other medications. The primary outcomes were whether switching of therapy was associated with a change of hemoglobin A1c (HbA1c) and whether weight gain occurred. Results. Baseline HbA1c was 8.0±0.9%. It decreased to 7.3±0.9% at 3 months after switching (P<0.01) and to 7.2±0.9% at 4 months (P<0.05). Weight gain was 1.1 kg after 1 month (P<0.01) and 2.3 kg after 5 months (P<0.01). Conclusion. Switching to BOT with insulin glargine and sitagliptin improved glycemic control. The significant decrease of HbA1c demonstrated that this combination can counteract deterioration of glycemic control due to rebound hyperglycemia secondary to GLP-1 tachyphylaxis. However, weight gain remains a problem. |
| format | Article |
| id | doaj-art-93738a5845cc40ce8f2dd2d6c363fe1b |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-93738a5845cc40ce8f2dd2d6c363fe1b2025-02-03T01:01:39ZengWileyInternational Journal of Endocrinology1687-83371687-83452014-01-01201410.1155/2014/927317927317Basal-Supported Oral Therapy with Sitagliptin Counteracts Rebound Hyperglycemia Caused by GLP-1 TachyphylaxisShu Meguro0Toshihide Kawai1Tomohiro Matsuhashi2Motoaki Sano3Keiichi Fukuda4Hiroshi Itoh5Yoshihiko Suzuki6Department of Internal Medicine, Division of Endocrinology, Metabolism and Nephrology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, JapanDepartment of Internal Medicine, Division of Endocrinology, Metabolism and Nephrology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, JapanDepartment of Internal Medicine, Division of Cardiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, JapanDepartment of Internal Medicine, Division of Cardiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, JapanDepartment of Internal Medicine, Division of Cardiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, JapanDepartment of Internal Medicine, Division of Endocrinology, Metabolism and Nephrology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, JapanHanzomon Diabetes City Atlas Clinic, 5-3-9 Ichiban-cho, Chiyoda-ku, Tokyo 102-0082, JapanIntroduction. Treatment with a glucagon-like peptide 1 (GLP-1) analog fails in some patients due to rebound hyperglycemia caused by tachyphylaxis (GLP-1 tachyphylaxis). We investigated the efficacy of basal-supported oral therapy (BOT) with insulin glargine and sitagliptin for counteracting GLP-1 tachyphylaxis. Materials and Methods. The subjects were 12 men and 3 women aged 59.9±10.0 years who had been treated with GLP-1 analogs. All of them had developed rebound hyperglycemia caused by GLP-1 tachyphylaxis. Their GLP-1 analog-based therapy was switched to BOT with insulin glargine plus sitagliptin and other medications. The primary outcomes were whether switching of therapy was associated with a change of hemoglobin A1c (HbA1c) and whether weight gain occurred. Results. Baseline HbA1c was 8.0±0.9%. It decreased to 7.3±0.9% at 3 months after switching (P<0.01) and to 7.2±0.9% at 4 months (P<0.05). Weight gain was 1.1 kg after 1 month (P<0.01) and 2.3 kg after 5 months (P<0.01). Conclusion. Switching to BOT with insulin glargine and sitagliptin improved glycemic control. The significant decrease of HbA1c demonstrated that this combination can counteract deterioration of glycemic control due to rebound hyperglycemia secondary to GLP-1 tachyphylaxis. However, weight gain remains a problem.http://dx.doi.org/10.1155/2014/927317 |
| spellingShingle | Shu Meguro Toshihide Kawai Tomohiro Matsuhashi Motoaki Sano Keiichi Fukuda Hiroshi Itoh Yoshihiko Suzuki Basal-Supported Oral Therapy with Sitagliptin Counteracts Rebound Hyperglycemia Caused by GLP-1 Tachyphylaxis International Journal of Endocrinology |
| title | Basal-Supported Oral Therapy with Sitagliptin Counteracts Rebound Hyperglycemia Caused by GLP-1 Tachyphylaxis |
| title_full | Basal-Supported Oral Therapy with Sitagliptin Counteracts Rebound Hyperglycemia Caused by GLP-1 Tachyphylaxis |
| title_fullStr | Basal-Supported Oral Therapy with Sitagliptin Counteracts Rebound Hyperglycemia Caused by GLP-1 Tachyphylaxis |
| title_full_unstemmed | Basal-Supported Oral Therapy with Sitagliptin Counteracts Rebound Hyperglycemia Caused by GLP-1 Tachyphylaxis |
| title_short | Basal-Supported Oral Therapy with Sitagliptin Counteracts Rebound Hyperglycemia Caused by GLP-1 Tachyphylaxis |
| title_sort | basal supported oral therapy with sitagliptin counteracts rebound hyperglycemia caused by glp 1 tachyphylaxis |
| url | http://dx.doi.org/10.1155/2014/927317 |
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