Effect of switching to teneligliptin from other dipeptidyl peptidase-4 inhibitors on glucose control and renoprotection in type 2 diabetes patients with diabetic kidney disease.
AIMS/INTRODUCTION
The objective of the present study was to elucidate the effect of switching to teneligliptin from other dipeptidyl peptidase-4 (DPP-4) inhibitors on glucose control and renoprotection in type 2 diabetes mellitus patients with diabetic kidney disease.


MATERIALS AND METHODS
The present study was a single-arm, open-label, observational study. A total of 23 patients, who had urinary albumin/creatinine ratios (UACR) ≥30 mg/gCr in their first urine in the early morning, and received other DPP-4 inhibitors and renin-angiotensin system inhibitors, switched to teneligliptin 20 mg/day. After switching to teneligliptin for 24 weeks, we evaluated changes in glycated hemoglobin (HbA1c), fasting plasma glucose levels, plasma DPP-4 activity and UACR.


RESULTS
HbA1c, fasting plasma glucose and UACR values showed no significant change after 24 weeks compared with baseline. However, plasma DPP-4 activity was significantly reduced after 24 weeks (0.57 ± 0.26 nmol/min/mL, P = 0.012, vs baseline), compared with baseline (1.49 ± 1.73 nmol/min/mL), and there was a positive relationship between the change rate of plasma DPP-4 activity (Δ%DPP-4) for 24 weeks and the levels of plasma DPP-4 activity (r = -0.5997, P = 0.0025) and fasting plasma glucose (r = -0.4235, P = 0.0440) at baseline. Additionally, the Δ%DPP-4 for 24 weeks was significantly correlated to the change rate of UACR (r = 0.556, P = 0.0059). However, there was no relationship between Δ%DPP-4 and ΔHbA1c (amount of HbA1c change).


CONCLUSIONS
Switching to teneligliptin from other DPP-4 inhibitors for 24 weeks reduces plasma DPP-4 activity, which is associated with a reduction in albuminuria, independent of the change in glucose levels, in type 2 diabetes mellitus patients with diabetic kidney disease.
['Kitada|Munehiro|M|http://orcid.org/0000-0002-3854-1385', 'Ogura|Yoshio|Y|', 'Nitta|Kyoko|K|', 'Fujii|Mizue|M|', 'Kanasaki|Keizo|K|http://orcid.org/0000-0002-9563-502X', 'Konishi|Kazunori|K|', 'Iida|Yasuo|Y|', 'Nakagawa|Atsushi|A|', 'Koya|Daisuke|D|']
D000368:Aged D015415:Biomarkers D001786:Blood Glucose D016022:Case-Control Studies D003924:Diabetes Mellitus, Type 2 D003928:Diabetic Nephropathies D054873:Dipeptidyl-Peptidase IV Inhibitors D005260:Female D005500:Follow-Up Studies D006442:Glycated Hemoglobin A D006801:Humans D007003:Hypoglycemia D015994:Incidence D007564:Japan D008297:Male D011379:Prognosis D011446:Prospective Studies D011720:Pyrazoles D053778:Thiazolidines
Teneligliptin Diabetic kidney disease Plasma DPP-4 activity