A Brief Note On Diabetes And The Treatment Of Type 1...

Review Article Introduction: Type 1 diabetes, also known as insulin-dependent diabetes, is a chronic condition in which body produces little to no insulin due to autoimmune destruction of the beta cells of the pancreas. Patient with Type 1 diabetes are mainly treated with subcutaneous insulin injection, along with dietary and lifestyle modification. Purpose of this article is to evaluate the role of DPP-4 inhibitors in the treatment of Type 1 diabetes mellitus. DPP-4 inhibitors inhibit the degradation of the incretin hormones, which is responsible for release and synthesis of insulin from pancreatic beta cells and also reduce glucagon secretion from pancreatic alpha cells. Method/Result: The literature search has been done using the†¦show more content†¦The primary outcome of the trial was to evaluate the change in insulin requirement and secondary outcomes were risk of hypoglycemia and preservation of C-peptide secretion at the end of the year. At the end of the year, the decrease in insulin requirement was 15.2 ±9.5 and 23.7 ±13.9 for group 1 and group 2 respectively, which shows the significant reduction of insulin requirement from baseline. There were no statistical significant difference found for risk of hypoglycemia and preservation of C-peptide secretion (p value 0.6828 vs 0.9368) at the end of the year. The limitations of the trail were small sample size and short observation period. In the second trial, 20 adults with Type 1 diabetes were enrolled in a double-blind, randomized, crossover study for 8 weeks. Patients included in the trial were 18 to 70 years old, diagnosed with Type 1 diabetes, were on insulin therapy and HbA1c between 8.5 and 12 %. Patients were excluded from trail if they were on metformin, pramlintide or a GLP-1 agonist, had known allergy to adhesives or DPP-4 inhibitors, Cr 0.1 mmol/L or a calculated CrCl 50 ml/min. Patients were randomly assigned to sitagliptin 100 mg/day or placebo for 4 weeks and then crossed over. The outcomes of the trial were evaluated using 2-h postprandial blood glucose and 24-h AUC changes in glucose levels from continuous glucose monitoring, HbA1c, fructosamine and insulin dose.