A Kushiyama

A Sathananthan

AD Baron

AJ Scheen

B Göke

B Merino

C Triplitt

CJ Li

CY Pan

DA Luis de

DJ Drucker

DR Whiting

DT Villareal

E Hall

FK Knop

G Panina

H Ishihara

J Gromada

JI Bagger

JL Jamaluddin

JS Moon

K Esposito

M Sjöstrand

MA Nauck

P Hollander

P Shah

S Herzberg-Schäfer

SE Inzucchi

T Dayeh

W Yang

X Wang

Y Otsuka

English

Abstract
                Background
                Dipeptidyl peptidase-4 (DPP-4) inhibitors are widely used as second-option medications when metformin fails. Variance of the glycated hemoglobin (HbA1c) response to DPP-4 inhibitions in patients with type 2 diabetes mellitus
 (T2DM) has been observed, but the characteristics which predict the response to DPP-4 inhibitor therapy are unclear. The aim of this study was to investigate the characteristics of α- and β-cell functions which might predict the efficacy of saxagliptin and facilitate personalization of treatment.
              
                Methods
                We studied 60 patients with T2DM who had inadequate glycemic control [HbA1c7.0–13.0% (53–119 mmol/mol)) with metformin alone. The patients were treated with saxagliptin (5 mg, daily) and metformin (1000–2000 mg as former) for 12 weeks. Oral glucose tolerance tests were carried out at baseline and endpoint to evaluate α- and β-cell functions, and blood C-peptide, insulin, glucagon levels were tested. Blood glucose, HbA1c and weight were also observed.
              
                Results
                Significant reduction of weight, HbA1c and glucagon was observed after 12-week treatment, while C-peptide, insulin and homeostasis model assessment-β increased (P &lt; 0.05). Linear regression and receiver operating characteristic analysis showed that baseline HbA1c and 30 min-glucagon were correlated with the HbA1c response to saxagliptin, while the weight loss was correlated with gender, age and fasting-insulin level. Further analysis showed the 30 min-glucagon of 49.1 pmol/L was the optimal cutoff value to predict the efficacy of saxagliptin.
              
                Conclusions
                Saxagliptin added to metformin significantly improved glycemic control and α- and β-cell function. Blood glucagon level was a good predicting factor for the HbA1c response to saxagliptin, and it will help appropriate patient selection.
              
                Trial registration
                Chinese Clinical Trial Register identifier, ChiCTR-PPR-15007045.
              </jats:sec

Hao Liu

Yun Hu

Feng-fei Li

Bing-li Liu

Xiao-fei Su

Jian-hua Ma

Crossref

Diabetes Therapy

Blood Glucagon Levels Predict the Hemoglobin A1c Response to Saxagliptin in Patients with Type 2 Diabetes Inadequately Controlled with Metformin

https://link.springer.com/content/pdf/10.1007%2Fs13300-016-0200-0.pdf

Blood Glucagon Levels Predict the Hemoglobin A1c Response to Saxagliptin in Patients with Type 2 Diabetes Inadequately Controlled with Metformin

Abstract

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