[LADA] DPP-4i is used in the treatment of latent autoimmune diabetes in adults. What is the effect?

Author: Medical team doctors report NMT NMT ENDO finishing compiler, please do not reprint without authorization.

Introduction: At the annual meeting of the American Society of Endocrinology (ENDO2021), Dr.
Luz Margaret Alanes Escueta from St.
Luke Medical Center in the Philippines shared with us about the "assessment of dipeptidyl peptidase 4 inhibitors (DPP-4i) A systematic review and meta-analysis study on the therapeutic effect of latent autoimmune diabetes (LADA) in adults.

The results show that compared with conventional treatments, DPP-4i has a good trend in improving blood glucose and improving or maintaining β-cell function in LADA patients, but it has not reached a statistically significant difference.
It is recommended that DPP-4i be the main drug in the future.
Sexual research to explore.

 DPP-4i and LADA DPP-4i are commonly used drugs for the treatment of type 2 diabetes.
Except for lowering blood sugar, it can also exert anti-inflammatory and immunomodulatory effects.
Previous in vitro studies have shown that DPP-4i can reduce pancreatic islet inflammation and improve β-cell function.

 LADA is a kind of autoimmune diabetes, and the patient has some clinical manifestations of T1DM and T2DM at the same time.

At present, insulin is considered to be the first choice for the treatment of LADA patients, but there have been studies exploring the application of DPP-4i in LADA patients, and this item has been reviewed systematically.

 Study description This study conducted a systematic review and meta-analysis of previous studies in order to evaluate the efficacy of DPP-4i in the treatment of LADA.

 Researchers searched POPLINE, Medline, Google Scholar, Web of Science, Wiley Online Library, Embase, PubMed, and Cochrane Library databases for literature and data related to the treatment of DPP-4i in adult LADA patients.

In addition, unpublished relevant data on ClinicalTrials.
gov was also analyzed.

 The research objectives are β-cell function (assessed based on C-peptide levels), maintenance of β-cell function (compared with baseline at the end of the test), and blood glucose control (based on HbA1c and fasting blood glucose levels).

 DPP-4i has the potential to improve blood glucose and β-cell function in LADA patients.
A total of 7 studies were included in this meta-analysis, with a total of 390 subjects in the DPPi group and the conventional treatment group (LADA).

 The results of the study showed that although the statistical difference was not reached, the use of DPP-4i in LADA patients improved the β cell function of patients [based on C peptide level: -0.
39 (-1.
03, 0.
25), P=0.
24)], β cell function maintenance [ According to the C peptide level: -0.
01 (-0.
25, 0.
23), P=0.
93], the tendency of blood sugar control [HbA1c: -0.
22 (-0.
47, 0.
03), P=0.
08].

 At baseline, there was heterogeneity between the DPP-4i treatment group and the standard treatment group in terms of C-peptide levels, which may be related to differences in the types of drugs used by the patients, age, and the course of diabetes.

However, the two groups had no heterogeneity in the changes in baseline HbA1c levels and C-peptide levels.

 Research conclusions This study shows that DPP4i used in the treatment of adult latent autoimmune diabetes has shown a safe and effective trend in improving blood sugar control, improving β cell function, and maintaining β cell function, but it has not reached statistical significance.

It is recommended that a larger prospective trial be conducted in the future to study DPP4i as the main drug to evaluate its therapeutic effect.