Once-weekly DPP-4 inhibitor delivers in type 2 diabetes

Switching from once-daily to once-weekly dipeptidyl peptidase 4 (DPP-4) inhibitors works to maintain fasting plasma glucose and time in range in patients with type 2 diabetes mellitus (T2DM), a study has shown.

The study included 36 T2DM patients treated with once-daily DPP-4 inhibitors for at least 12 weeks. They were randomized to either continue once-daily DPP-4 inhibitors or switch to omarigliptin, a once-weekly DPP-4 inhibitor, for 24 weeks.

The primary endpoints were changes in oxidative stress, evaluated using the diacron-reactive oxygen metabolite (d-ROMs) test, and glucose variability using flash glucose monitoring. Changes in the diabetes treatment satisfaction questionnaire (DTSQ) scores were also assessed.

Changes in d-ROMs and DTSQ scores after 24 weeks of treatments were similar in the two treatment groups. However, omarigliptin showed superiority over once-daily DPP-4 inhibitors in controlling fasting plasma glucose and time in range.

Of note, fasting plasma glucose and time in range at 24 weeks remained stable in the group of patients who switched to omarigliptin, whereas the parameters increased in the group of those who received maintenance therapy with once-daily DPP-4 inhibitors.

There were no statistically significant changes seen in haemoglobin A1c between the two groups.

Once-weekly dipeptidyl peptidase 4 inhibitors have been developed in addition to the once-daily preparations, with the former believed to improve compliance by reducing the burden of medication. [Diabetes Care 2018;41:e52-e55]