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

Diyabetik Hastalarda DPP-4 İnhibitörleri Kullanımının Gastroparezik Semptomlar Üzerine Etkisi

Abstract

Amaç: Çalışmada tip 2 diabetes mellitus (T2DM) tanısı ile dipeptidil peptidaz 4 enzim inhibitörleri (DPP-4-İ) kullanan hastalarda, DPP-4-İ’nin diyabetik gastroparezi semptomları üzerine etkilerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Şubat 2022-Temmuz 2022 tarihleri aralığında Ankara Üniversitesi Tıp Fakültesi, Endokrinoloji Kliniği’nde T2DM tanısı ile takip edilen 203 hasta çalışmaya alındı. Tüm hastalarda gastroparezi semptomları sorgulaması; Gastroparezi Ana Semptom İndeksi (GCSI) anketine göre değerlendirildi. Bulgular: Çalışmamızda toplam 203 hasta değerlendirilmiş olup hastaların 114’ü (%56,2) kadın, 89’u (%43,8) erkekti ve ortanca [çeyrekler aralığı (ÇA)] hemoglobin A1c (HbA1c) düzeyleri 7,9 (3), rtanca (ÇA) diyabetli hastalık süreleri 12 (14) yıl olarak tespit edildi. Hastalarımızda gastroparezi semptomları sorgulamasına yönelik yapılan GCSI anketine göre alt gruplar içinde bulantı-kusma bölümü (p=0,50), şişkinlik bölümü (p=0,24) ve ortalama total skor (p=0,14) olup sonuçların her iki grupta benzer olduğu saptandı. Ancak erken doyma/postprandial tokluk hissi bölümü sorgulandığında DPP-4-İ kullanan diyabetik hasta grubunda gastroparezi semptom skorunun daha düşük olduğu bulundu (p=0,048). Kullanılan DPP-4-İ grubu ilaçlar arasında da gastroparezi semptom skoru açısından bir fark bulunmamıştır (p=0,50). Sonuç: Diyabetik hastalarda düşünülenin aksine, DPP-4-İ’nin kullanımı sonrası erken doyma/postprandial tokluk hissi bölümünde gastroparezi semptom skoru daha düşük saptanmıştır. Ancak yaş, hastalık süresi, HbA1c gibi değerler ile GCSI skorları arasında anlamlı bir korelasyon bulunmamıştır

Keywords

• Diabetes mellitus
• DPP-4 enzim inhibitörleri
• gastroparezi

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