title: DPP-4 INHIBITOR THERAPY IN PATIENTS AFTER PANCREATIC TRANSPLANT.
abstract: OBJECTIVE
  Management of new onset hyperglycemia after pancreas transplantation (PT) is not well studied. There is a lack of information on effective and safe management options for hyperglycemia after PT. We tested the hypothesis that early intervention for hyperglycemia using a dipeptidyl peptidase-4 (DPP-4) inhibitor prolongs insulin-free graft function in patients after PT.
  
  
  METHODS
  Twenty-six patients who developed noninsulin-dependent hyperglycemia at least 1 year after PT met the inclusion criteria for this retrospective chart review. Sitagliptin, a DPP-4 inhibitor, was a commonly used therapy for hyperglycemia after PT due to its wide availability and coverage. The standard therapy group included patients who did not receive any oral or noninsulin injection therapy until insulin was clearly required to control hyperglycemia. The intervention group included patients who had received sitagliptin soon after hyperglycemia developed. The median follow-up period was 45 months. The time to hyperglycemia from 1 year after PT and time to insulin requirement after hyperglycemia development were compared between these 2 groups.
  
  
  RESULTS
  The time to hyperglycemia after PT was not different between the groups, but the time to insulin requirement was significantly longer in the intervention group compared with the standard therapy group (P<.001). After adjusting for body mass index (BMI), the difference remained significant (P<.001).
  
  
  CONCLUSIONS
  Early treatment of hyperglycemia after PT with a DPP-4 inhibitor such as sitagliptin prolongs the time to insulin therapy compared with a standard observation approach. Prospective studies are needed to further investigate this observation.
authors: Ahmet B
authors: AB
authors: Ergin
authors: Emilio
authors: E
authors: Poggio
authors: Venkatesh
authors: V
authors: Krishnamurthi
authors: Tania
authors: T
authors: Jaber
authors: Betul A
authors: BA
authors: Hatipoglu
mesh_terms: D000328:Adult; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D012189:Retrospective Studies; D000068900:Sitagliptin Phosphate / Q000627:therapeutic use*
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D000068900:Sitagliptin Phosphate