Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients with Diabetes Mellitus
Abstract
Objectives: This study aimed to investigate potential effects of dipeptidyl peptidase 4 enzyme inhibitors (DPP-4-I) on gastroparesis symptoms in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: The study sample consisted of 203 patients with T2DM followed up between February and July 2022 at the Endocrinology Clinic of Ankara University Faculty of Medicine. Gastroparesis symptoms were assessed in all patients through the Gastroparesis Cardinal Symptom Index (GCSI).
Results: A total of 203 patients were evaluated in our study, 114 (56.2%) of the patients were women, 89 (43.8%) were men, and the median [interquartile range (IQR)] hemoglobin A1c (HbA1c) levels were 7.9 (3), and the median (IQR) diabetes disease duration was determined as 12 (14) years. According to the GCSI questionnaire conducted to question the symptoms of gastroparesis in our patients, the nausea/vomiting section (p=0.50), bloating section (p=0.24), and mean total score (p=0.14) were found to be similar in both groups. However, when the feeling of early satiety/postprandial fullness was questioned, it was observed that the gastroparesis symptom score was lower in the diabetic patient group using DPP-4-I (p=0.048). No significant difference in gastroparesis scores was observed between different DPP-4-I medications (p=0.50).
Conclusion: Contrary to expectations, Contrary to expectations, gastroparesis symptom scores were found to be lower in the early satiety/ postprandial fullness section after the use of DPP-4-I. However, there was no significant correlation between age, disease duration, HbA1c, and GCSI.
Keywords
Diabetes mellitus, DPP-4 enzyme inhibitors, gastroparesis
Ethical Statement
Çalışma için Ankara Üniversitesi Tıp Fakültesi Klinik Araştırmalar ve Etik Kurulu’ndan onay alınmıştır (tarih: 16.02.2022, karar no: İ02-86-22).
References
- 1. Chang J, Rayner CK, Jones KL, et al. Diabetic gastroparesis-backwards and forwards. J Gastroenterol Hepatol. 2011;26 Suppl 1:46-57.
- 2. Ye Y, Jiang B, Manne S, et al. Epidemiology and outcomes of gastroparesis, as documented in general practice records, in the United Kingdom. Gut. 2021;70:644-653.
- 3. Dilmaghani S, Zheng T, Camilleri M. Epidemiology and healthcare utilization in patients with gastroparesis: a systematic review. Clin Gastroenterol Hepatol. 2023;21:2239-2251.e2.
- 4. Revicki DA, Rentz AM, Dubois D, et al. Gastroparesis Cardinal Symptom Index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004;13:833-844.
- 5. Canpolat AG, Kav T, Sivri B, et al. Effects of L-thyroxine on gastric motility and ghrelin in subclinical hypothyroidism: a prospective study. J Clin Endocrinol Metab. 2013;98:E1775-9.
- 6. Türkiye Endokrinoloji ve Metabolizma Derneği Diabetes Mellitus Çalışma ve Eğitim Grubu. Diabetes mellitus ve komplikasyonlarının tanı, tedavi ve izlem kılavuzu. 2022;97-98.
- 7. Türkiye Endokrinoloji ve Metabolizma Derneği Diabetes Mellitus Çalışma ve Eğitim Grubu. Diabetes mellitus ve komplikasyonlarının tanı, tedavi ve izlem kılavuzu. 2022;95-96.
- 8. Drucker DJ, Nauck MA. The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet. 2006;368:1696-1705.
- 9. Ma J, Rayner CK, Jones KL, et al. Diabetic gastroparesis: diagnosis and management. Drugs. 2009;69:971-986.
- 10. Bytzer P, Talley NJ, Leemon M, et al. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med. 2001;161:1989-1996.