Add-on linagliptin improves glucose control in persistent IGT

After 12 months of metformin and consistent lifestyle changes, patients who still showed impaired glucose tolerance (IGT) seem to benefit from the addition of linagliptin to their regimen, leading to improvements in glucose concentrations and pancreatic β-cell function, a recent study has found.

Researchers randomly assigned eligible participants to either continue their metformin + lifestyle regimen (M group; n=12) or to receive additional linagliptin medication (LM group; n=19). Participants were followed up every 6 months, during which medication efficacy and tolerance were assessed.

After 6 months of intervention, participants in the LM group saw significant reductions in body weight, mean blood pressure, waist circumference, and body mass index (p<0.05 for all), though significance was attenuated when compared to the M group.

Oral glucose tolerance test (OGTT) revealed a small, nonsignificant drop in glucose levels in the M group (60-minute: –13±12 mg/dL; 120-minute: –10±9 mg/dL). In the LM group, blood glucose levels decreased significantly over 6 months of observation (60-minute: –52±12 mg/dL; 120-minute: –38±10 mg/dL; p<0.05 for both). Notably, the inter-group differences in change values were also statistically significant (p<0.05 for both).

Pancreatic β-cell function was measured using the disposition index, which showed that the LM group saw a 76-percent improvement (p<0.05), while the M group recorded a slight but nonsignificant decrease. By the end of the study period, the difference in β-cell function was statistically significant between groups in favour of LM (p<0.05).

“The addition of linagliptin in patients with persistent IGT after 12 months of treatment with lifestyle modification + metformin improves glucose levels during OGTT and pancreatic β-cell function,” the researchers said. “This approach should be evaluated in larger sample size population [and] longer duration studies to identify more effective therapies to improve pancreatic β-cell function and reduce or delay type 2 diabetes onset.”