Abstract

A STUDY ON THE EFFECT OF TENELIGLIPTIN VERSUS SULFONYLUREAS IN EARLY RENAL FAILURE PATIENTS WITH TYPE 2 DIABETES MELLITUS

Jancy George, Libi Idicula*, Vicky Mary Johnson and Rani Manju, Dr. Subhash B. Pillai MD DM and Dr. Santhosh M. Mathews

ABSTRACT

Approximately 150 million people have diabetes mellitus worldwide, and this number may well double by the year 2025. Nephropathy is one of the most prevalent complications of diabetes.The objective of our project was to study the effect of teneligliptin versus sulfonylureas in early renal failure patients with type 2 diabetes mellitus. The prospective observational study was conducted at the outpatient Department of Nephrology, Pushpagiri Medical College Hospital for a uration of six months after getting approval from Institutional Ethics Committee. 90 patients who gave consent (60 males, 30 females) were enrolled in 2 groups, among which 45 were included in teneligliptin group (20 mg) and other 45 in sulfonylureas group (glimepiride 1mg/glipizide 5 mg) based on inclusion and exclusion criteria. Data collection was done initially, and after 3 months of treatment. The data was analysed using one paired t- test. The Urine Protein- Creatinine(UPC) ratio was significantly declined in teneligliptin group while increased in sulfonyureas group (-0.63 versus +0.71, p =0.016). Estimated glomerular filtration rate(eGFR) was improved by teneligliptin group while worsened by sulfonylureas (+2.64ml/min/1.73m2 versus -5.7ml/min/1.73m2) with statistical significance (p =0.03). There was non-inferiority between both the treatment groups in terms of FBS and HbA1C(p=0.12,p=0.23 respectively). Teneligliptin produced statistically significant mean body weight reduction as compared to sulfonylureas induced weight gain (-1.72 kg versus +1.38 kg, p=0.02). No hypoglycemic episodes were exhibited by teneligliptin group. On consideration of its reno-protective effect and safety teneligliptin is preferred over sulfonylureas in early renal failure patients.

Keywords: Teneligliptin, dipeptidyl peptidase -4 inhibitors, sulfonylureas, urine protein creatinine ratio, glipizide, glimepiride.