Abstract
The aim of this study was to evaluate the effects of alogliptin benzoate (alogliptin), a dipeptidase-4 inhibitor, as mono-therapy for hemodialysis (HD) patients with type2 diabetes. Among 381 HD patients, 16 diabetic HD patients (13 males and 3 females) with inadequate glycemic control (hemoglobin A1c (HbA1c) levels>6.1% and glycated albumin (GA) levels>20%) on exercise and diet were eligible to participate. No patients were taking other oral antidiabetic drugs nor receiving insulin injection therapy. The mean age was 62.5±9.2 years. Alogliptin was administered to patients at 6.25mg once a day. The following parameters were examined before and after treatment: levels of HbA1c, GA, blood glucose, insulin, C-peptide immunoreactivity, glucagon, and active glucagon like peptide-1 (GLP-1). All samples were obtained before the start of HD treatment. Significance was tested using the Wilcoxon signed-rank test for nonparametric data. HbA1c and GA levels significantly decreased in 8 weeks after the start of the administration of Alogliptin in comparison with before treatment (p<0.05). HbA1c and GA levels decreased from 6.7±0.2 to 5.6±0.2% and from 22.5±0.7 to 19.7±0.5% in 40 weeks after treatment. Among the 16 patients, 13 (81.3%) achieved HbA1c<6.1% and GA<20%. GLP-1 levels were 8.9±5.7pmol/L before treatment and these levels significantly increased by doubling after treatment (p<0.05). None of the patients exhibited significant adverse effects such as hypoglycemia, except one patient who experienced a drug rash event. Alogliptin is expected as one of the new treatment strategies for hemodialysis patients with diabetes whose choices of diabetic treatment are limited.
