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Vildagliptin recommended for treating prediabetes
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Treatment with vildagliptin for 12 weeks produced the same improvements in individuals with impaired glucose tolerance as it did in those with type 2 diabetes.
The beneficial effects of vildagliptin (Galvus, Novartis) on incretin levels and islet function are already known in patients with type 2 diabetes. Now, researchers have reproduced these effects in 179 patients with prediabetes.
Results of the double-blind, randomized, parallel-group study showed that after 12 weeks, vildagliptin reduced postprandial glucose excursions by 32%, increased glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide and decreased glucagon in the prediabetic population. The DPP-IV inhibitor also led to increased beta cell function.
The data revealed no significant weight gain or hypoglycemia associated with vildagliptin. The drug was well-tolerated and there were no significant adverse events. According to the researchers, vildagliptin may be a good candidate in this prediabetic population, but further studies are warranted. – by Katie Kalvaitis
Diabetes Care. 2008;31:30-35.
This paper provides evidence that vildagliptin, a member of the new class of antidiabetic drugs called DPP-IV inhibitors, improves the metabolic profile in subjects with impaired glucose tolerance. The overall response to drug treatment was similar to what has been described in trials of diabetic patients with DPP-IV inhibitors: increased levels of GLP-1, reduced levels of glucagon, and maintenance of insulin levels despite lower blood glucose. The interesting feature here is the improvement of glucose metabolism in a group of subjects who have prediabetes, but who share an increased risk for cardiovascular disease with diabetic patients. Vildagliptin was well-tolerated in the subjects with impaired glucose tolerance as it has been in patients with diabetes. While these results do not support widespread treatment of prediabetes with DPP-IV inhibitors they set the stage for larger and longer trials of these medications to examine potential benefits in this patient group.
– David D’Alessio, MD
Director, Division of Endocrinology, University of Cincinnati