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Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients with Diabetes Mellitus

Year 2024, Volume: 77 Issue: 4, 404 - 409, 31.12.2024

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.

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).

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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.
  • 11. Janatuinen E, Pikkarainen P, Laakso M, et al. Gastrointestinal symptoms in middle-aged diabetic patients. Scand J Gastroenterol. 1993;28:427-432.
  • 12. Enck P, Rathmann W, Spiekermann M, et al. Prevalence of gastrointestinal symptoms in diabetic patients and non-diabetic subjects. Z Gastroenterol. 1994;32:637-641.
  • 13. Maleki D, Locke GR 3rd, Camilleri M, et al. Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med. 2000;160:2808-2816.
  • 14. Rayner CK, Samsom M, Jones KL, et al. Relationships of upper gastrointestinal motor and sensory function with glycemic control. Diabetes Care. 2001;24:371-381.
  • 15. Fraser RJ, Horowitz M, Maddox AF, et al. Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1990;33:675-680.
  • 16. Aswath GS, Foris LA, Ashwath AK, et al. Diabetic Gastroparesis. 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430794/
  • 17. Jung HK, Choung RS, Locke GR 3rd, et al. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology. 2009;136:1225-1233.
  • 18. Cassilly DW, Wang YR, Friedenberg FK, et al. Symptoms of gastroparesis: use of the gastroparesis cardinal symptom index in symptomatic patients referred for gastric emptying scintigraphy. Digestion. 2008;78:144-151.
  • 19. Revicki DA, Camilleri M, Kuo B, et al. Development and content validity of a gastroparesis cardinal symptom index daily diary. Aliment Pharmacol Ther. 2009;30:670-680.
  • 20. Aulinger BA, Bedorf A, Kutscherauer G, et al. Defining the role of GLP-1 in the enteroinsulinar axis in type 2 diabetes using DPP-4 inhibition and GLP- 1 receptor blockade. Diabetes. 2014;63:1079-1092.
  • 21. Stevens JE, Buttfield M, Wu T, et al. Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes. Diabetes Obes Metab. 2020;22:51-58.
  • 22. Nonaka T, Sekino Y, Iida H, et al. Early effect of single-dose sitagliptin administration on gastric emptying: crossover study using the (13)C breath test. J Neurogastroenterol Motil. 2013;19:227-232.

Diyabetik Hastalarda DPP-4 İnhibitörleri Kullanımının Gastroparezik Semptomlar Üzerine Etkisi

Year 2024, Volume: 77 Issue: 4, 404 - 409, 31.12.2024

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

Ethical Statement

-

Supporting Institution

-

Project Number

-

Thanks

-

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.
  • 11. Janatuinen E, Pikkarainen P, Laakso M, et al. Gastrointestinal symptoms in middle-aged diabetic patients. Scand J Gastroenterol. 1993;28:427-432.
  • 12. Enck P, Rathmann W, Spiekermann M, et al. Prevalence of gastrointestinal symptoms in diabetic patients and non-diabetic subjects. Z Gastroenterol. 1994;32:637-641.
  • 13. Maleki D, Locke GR 3rd, Camilleri M, et al. Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med. 2000;160:2808-2816.
  • 14. Rayner CK, Samsom M, Jones KL, et al. Relationships of upper gastrointestinal motor and sensory function with glycemic control. Diabetes Care. 2001;24:371-381.
  • 15. Fraser RJ, Horowitz M, Maddox AF, et al. Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1990;33:675-680.
  • 16. Aswath GS, Foris LA, Ashwath AK, et al. Diabetic Gastroparesis. 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430794/
  • 17. Jung HK, Choung RS, Locke GR 3rd, et al. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology. 2009;136:1225-1233.
  • 18. Cassilly DW, Wang YR, Friedenberg FK, et al. Symptoms of gastroparesis: use of the gastroparesis cardinal symptom index in symptomatic patients referred for gastric emptying scintigraphy. Digestion. 2008;78:144-151.
  • 19. Revicki DA, Camilleri M, Kuo B, et al. Development and content validity of a gastroparesis cardinal symptom index daily diary. Aliment Pharmacol Ther. 2009;30:670-680.
  • 20. Aulinger BA, Bedorf A, Kutscherauer G, et al. Defining the role of GLP-1 in the enteroinsulinar axis in type 2 diabetes using DPP-4 inhibition and GLP- 1 receptor blockade. Diabetes. 2014;63:1079-1092.
  • 21. Stevens JE, Buttfield M, Wu T, et al. Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes. Diabetes Obes Metab. 2020;22:51-58.
  • 22. Nonaka T, Sekino Y, Iida H, et al. Early effect of single-dose sitagliptin administration on gastric emptying: crossover study using the (13)C breath test. J Neurogastroenterol Motil. 2013;19:227-232.
There are 22 citations in total.

Details

Primary Language English
Subjects Endocrinology
Journal Section Articles
Authors

Fatma Avcı Merdin This is me 0000-0003-4753-1354

Ali Berkay Kandemir 0009-0000-4938-148X

Buket Beyazoğlu 0009-0007-8931-4995

Buse Bayrakçı 0009-0006-2192-4407

Kaan Gürkan Gürel 0009-0000-2437-2712

Samed Sezer 0009-0000-4941-9097

Sami Aydoğdu 0009-0002-9552-4773

Asena Gökçay Canpolat 0000-0003-1186-2960

Project Number -
Publication Date December 31, 2024
Submission Date January 18, 2024
Acceptance Date December 24, 2024
Published in Issue Year 2024 Volume: 77 Issue: 4

Cite

APA Avcı Merdin, F., Kandemir, A. B., Beyazoğlu, B., … Bayrakçı, B. (2024). Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients with Diabetes Mellitus. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 77(4), 404-409. https://doi.org/10.4274/atfm.galenos.2024.04900
AMA Avcı Merdin F, Kandemir AB, Beyazoğlu B, et al. Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients with Diabetes Mellitus. Ankara Üniversitesi Tıp Fakültesi Mecmuası. December 2024;77(4):404-409. doi:10.4274/atfm.galenos.2024.04900
Chicago Avcı Merdin, Fatma, Ali Berkay Kandemir, Buket Beyazoğlu, Buse Bayrakçı, Kaan Gürkan Gürel, Samed Sezer, Sami Aydoğdu, and Asena Gökçay Canpolat. “Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients With Diabetes Mellitus”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77, no. 4 (December 2024): 404-9. https://doi.org/10.4274/atfm.galenos.2024.04900.
EndNote Avcı Merdin F, Kandemir AB, Beyazoğlu B, Bayrakçı B, Gürel KG, Sezer S, Aydoğdu S, Canpolat AG (December 1, 2024) Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients with Diabetes Mellitus. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77 4 404–409.
IEEE F. Avcı Merdin, A. B. Kandemir, B. Beyazoğlu, B. Bayrakçı, K. G. Gürel, S. Sezer, S. Aydoğdu, and A. G. Canpolat, “Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients with Diabetes Mellitus”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 77, no. 4, pp. 404–409, 2024, doi: 10.4274/atfm.galenos.2024.04900.
ISNAD Avcı Merdin, Fatma et al. “Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients With Diabetes Mellitus”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77/4 (December2024), 404-409. https://doi.org/10.4274/atfm.galenos.2024.04900.
JAMA Avcı Merdin F, Kandemir AB, Beyazoğlu B, Bayrakçı B, Gürel KG, Sezer S, Aydoğdu S, Canpolat AG. Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients with Diabetes Mellitus. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;77:404–409.
MLA Avcı Merdin, Fatma et al. “Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients With Diabetes Mellitus”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 77, no. 4, 2024, pp. 404-9, doi:10.4274/atfm.galenos.2024.04900.
Vancouver Avcı Merdin F, Kandemir AB, Beyazoğlu B, Bayrakçı B, Gürel KG, Sezer S, et al. Impact of DPP-4 Inhibitors on Gastroparesis Symptoms in Patients with Diabetes Mellitus. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;77(4):404-9.