title: Management of a prediabetes case with the DPP-4 inhibitor sitagliptin.
abstract: OBJECTIVE
  It is important to prevent or slow the progression of prediabetes to type 2 diabetes and, therefore, reduce the risk of long-term complications. New therapeutic options will allow more patients to be effectively managed. Although theorized to be effective for prediabetes, dipeptidyl peptidase-4 (DPP-4) inhibitors have not been studied in this population. The purpose of this article is to report the results of a case in which a patient with prediabetes was treated with the DPP-4 inhibitor, sitagliptin.
  
  
  METHODS
  A 56-year-old woman was diagnosed with prediabetes at a hemoglobin A1C (A1C) of 6.2%. After 6 months of consistent lifestyle modifications, her A1C was 6.3%, and she wanted to start a medication to prevent disease progression. Because of anticipated risk or intolerability with standard prediabetes treatments, she was started on sitagliptin 100 mg daily; 6 weeks later, she noted improvements in glucometer readings. After 18 months on sitagliptin, her A1C had improved to 5.8% without further lifestyle improvements, and by 32 months, her A1C had improved to 5.6%. Her A1C was maintained within or below the prediabetes range of 5.7% to 6.4% over 3 years of treatment with sitagliptin.
  
  
  CONCLUSIONS
  Although human studies with DPP-4 inhibitors are lacking, the available studies have shown improvements in β-cell function and postprandial and fasting glucose levels. Furthermore, animal studies have shown a delay in progression of prediabetes. No case reports have been found regarding DPP-4 inhibitor use in prediabetes.
  
  
  CONCLUSIONS
  Sitagliptin may have a role in treating prediabetes and should be further studied.
authors.affiliation: The University of Oklahoma College of Pharmacy, Tulsa, OK, USA.
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Johnson
authors.forename: Katherine S
authors.initials: KS
authors.lastname: O'Neal
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Pack
authors.forename: Minhye K
authors.initials: MK
authors.lastname: Kim
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000188:drug therapy*; D011719:Pyrazines / Q000627:therapeutic use*; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D006442:Glycated Hemoglobin; D011719:Pyrazines; D000068900:Sitagliptin Phosphate; D014230:Triazoles
keywords: DPP-4 inhibitor; prediabetes; sitagliptin; type 2 diabetes; β-cell