Thea Anine Strom Halden, MD, of Oslo University Hospital in Norway, and colleagues studied 19 long-term stable renal transplant recipients with new-onset diabetes after transplantation (NODAT). The patients had a median age of 67 years. The investigators randomized patients to receive either sitagliptin 50-100 mg/day for four weeks followed by a sitagliptin-free period of four weeks or vice versa. Results showed that sitagliptin significantly increased first- and second-phase insulin secretion and lowered fasting and postprandial plasma glucose levels. The drug was well tolerated, and the researchers observed no effect on endothelial function and plasma markers of cardiovascular risk and no serious adverse events, according to findings published online ahead of print in Nephrology Dialysis Transplantation.
“Thus, sitagliptin represents a novel treatment alternative for renal transplant recipients with NODAT, but long-term data on such therapy are warranted,” the authors wrote.
NODAT develops in 10%-15% of all renal transplant recipients within 10 weeks after transplantation. Oral therapeutic options for treating hyperglycemia in these patients are limited because of reduced renal function, potential interactions with immunosuppressive drugs, and adverse effects such as hypoglycemic events that may increase cardiovascular risk, Dr. Halden’s group explained.
Sitagliptin increases pancreatic insulin secretion and decreases glucagon release. Since these effects are glucose dependent, the drug does not induce hypoglycemia or weight gain, the researchers pointed out.