Diabetes therapies in hemodialysis patients: Dipeptidase-4 inhibitors  

作　　者：Yuya Nakamura Hitomi Hasegawa Mayumi Tsuji Yuko Udaka Masatomo Mihara Tatsuo Shimizu Michiyasu Inoue Yoshikazu Goto Hiromichi Gotoh Masahiro Inagaki Katsuji Oguchi 

机构地区：[1]Saiyu Soka Hospital [2]Department of Pharmacology, School of Medicine, Showa University [3]Department of Chemistry, College of Arts and Sciences, Showa University

出　　处：《World Journal of Diabetes》2015年第6期840-849,共10页世界糖尿病杂志（英文版）（电子版）

基　　金：Yuya Nakamura,MD,Saiyu Soka Hospital,1-21-37,Kitaya,Soka-city Saitama-ken 340-0046,[e-mail] Telephone:[phone] Fax:[phone]

摘　　要：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 A1 c 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.Although several previous studies have been publishedon the effects of dipeptidase-4 （DPP-4） inhibitors indiabetic hemodialysis （HD） patients, the findings haveyet to be reviewed comprehensively. Eyesight failurecaused by diabetic retinopathy and aging-relateddementia make multiple daily insulin injections difficultfor HD patients. Therefore, we reviewed the effectsof DPP-4 inhibitors with a focus on oral antidiabeticdrugs as a new treatment strategy in HD patients withdiabetes. The following 7 DPP-4 inhibitors are availableworldwide sitagliptin, vildagliptin, alogliptin, linagliptin,teneligliptin, anagliptin, and saxagliptin. All of theseare administered once daily with dose adjustmentsin HD patients. Four types of oral antidiabetic drugscan be administered for combination oral therapy withDPP-4 inhibitors, including sulfonylureas, meglitinide,thiazolidinediones, and alpha-glucosidase inhibitor. Ninestudies examined the antidiabetic effects in HD patients.Treatments decreased hemoglobin A1c and glycatedalbumin levels by 0.3% to 1.3% and 1.7% to 4.9%,respectively. The efficacy of DPP-4 inhibitor treatmentis high among HD patients, and no patients exhibitedsignificant severe adverse effects such as hypoglycemiaand liver dysfunction. DPP-4 inhibitors are key drugs innew treatment strategies for HD patients with diabetesand with limited choices for diabetes treatment.

关 键 词：Dipeptidase-4 INHIBITORS HEMODIALYSIS DIABETES MELLITUS Blood glucose-related factors Antiinflammatoryeffects 

分 类 号：R587.1[医药卫生—内分泌] R459.5[医药卫生—内科学]