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Deprecated: Implicit conversion from float 328.4 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 BMJ+Open+Diabetes+Res+Care 2018 ; 6 (1): ä Nephropedia Template TP
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Ursodeoxycholic acid potentiates dipeptidyl peptidase-4 inhibitor sitagliptin by enhancing glucagon-like peptide-1 secretion in patients with type 2 diabetes and chronic liver disease: a pilot randomized controlled and add-on study #MMPMID29607050
Shima KR; Ota T; Kato Ki; Takeshita Y; Misu H; Kaneko S; Takamura T
BMJ Open Diabetes Res Care 2018[]; 6 (1): ä PMID29607050show ga
Objective: We evaluated the effects of ursodeoxycholic acid (UDCA) on glucagon-like peptide-1 (GLP-1) secretion and glucose tolerance in patients with type 2 diabetes with chronic liver disease. Research design and methods: Japanese patients with type 2 diabetes (glycated hemoglobin (HbA1c) levels ?7.0%) and chronic liver disease were included in this study. Sixteen patients (HbA1c level, 7.2%±0.6%(55.2 mmol/mol)) were randomized to receive 900?mg UDCA for 12 weeks followed by 50?mg sitagliptin add-on therapy for 12 weeks (UDCA-first group; n=8) or 50?mg sitagliptin for 12 weeks followed by 900?mg UDCA add-on therapy for 12 weeks (sitagliptin-first group; n=8). All patients underwent a liquid high-fat meal test before and after 12 or 24 weeks of treatment. Results: The baseline characteristics were similar between the UDCA-first and sitagliptin-first groups. There was a decrease in body weight (72.5±8.4?to 70.6±8.6?kg; P=0.04) and the HbA1c level (7.0%±0.3%?to 6.4%±0.5%(53.0 to 46.4?mmol/mol); P=0.01) in the UDCA-first group. The HbA1c level decreased further after sitagliptin administration (6.4%±0.5%?to 6.0%±0.4%(46.4 to 42.1?mmol/mol); P<0.01). Although there were no initial changes in the weight and HbA1c level in the sitagliptin-first group, the HbA1c level decreased after UDCA addition (7.1%±1.1%?to 6.6%±0.9%(54.1 to 48.6?mmol/mol); P=0.04). UDCA alone increased the area under the curve0?30 for GLP-1 response (115.4±47.2?to 221.9±48.9?pmol·min/L; P<0.01), but not the glucose-dependent insulinotropic polypeptide response, in the UDCA-first group. Conclusions: UDCA treatment resulted in a greater reduction in HbA1c levels, and an increased early phase GLP-1 secretion. Trial registration number: NCT01337440.