• Valentina K. Bayrasheva
  • Ivan Y. Pchelin
  • Vladimir A. Dobronravov
  • Alina Yu Babenko
  • Svetlana G. Chefu
  • Ivan S. Shatalov
  • Volha N. Vasilkova
  • Natalia V. Hudiakova
  • Alexandra N. Ivanova
  • Pavel A. Andoskin
  • Elena N. Grineva

Objective: The aim of this randomized comparative study was to assess renal and metabolic effects of vildagliptin in insulin-treated type 2 diabetes (T2DM) patients without overt chronic kidney disease. Subjects and methods: We randomized 47 insulin-treated non-proteinuric patients with satisfactory controlled T2DM and estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m2 either to continue insulin therapy (control) or to receive combined insulin-vildagliptin treatment (VIG group). We assessed eGFR using serum creatinine (eGFRcreat), cystatin C (eGFRcys), and both (eGFRcreat-cys), and urinary creatinine-adjusted excretion of albumin (UACR), type IV collagen (uCol IV/Cr), and neutrophil gelatinase-associated lipocalin (uNGAL/Cr) at baseline and after 6 months of treatment. Results: Study groups were comparable in terms of age and sex (60.1 ± 6.1 years and 42.9% men in control group vs. 60.8 ± 5.2 years and 39.1% in VIG group). After 6 months of treatment, there were no significant changes in main assessed parameters in control group. VIG group demonstrated significant decrease in HbA1c, diastolic blood pressure, frequency of hypoglycemia, and high-sensitivity C-reactive protein level as compared to the changes in control group. While eGFRcreat, UACR, and uNGAL/Cr showed no significant changes after vildagliptin addition, eGFRcys, eGFRcreat-cys, and uCol IV/Cr changed significantly in comparison with control group (+7.0% [3.7;13.3]; +5.1% [1.4;8.5];-32,8% [-55.8;-24.4], respectively, p < 0.01 each). Correlation and regression analysis revealed glucose-independent pattern of these changes. Conclusion: Addition of vildagliptin to ongoing insulin therapy in patients with T2DM was associated with a reduction in uCol IV/Cr and an increase in eGFRcys and eGFRcreat-cys, independent of T2DM control parameters.

Original languageEnglish
Pages (from-to)418-426
Number of pages9
JournalArchives of endocrinology and metabolism
Volume64
Issue number4
DOIs
StatePublished - 1 Jan 2020

    Research areas

  • Cystatin C, NGAL, Renal function, Type 2 diabetes, Type IV collagen, Vildagliptin, cystatin C, type IV collagen, IV, NEPHROPATHY, BLOOD-PRESSURE, VARIABILITY, GLOMERULAR-FILTRATION-RATE, type 2 diabetes, CYSTATIN-C, CREATININE, HYPOGLYCEMIA, renal function, CHRONIC KIDNEY-DISEASE, ASSOCIATION

    Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

ID: 62429007