INTRODUCTION. The aim of this study was to assess the efficacy and safety of vildagliptin in subjects not achieving satisfactory glycemic control while on two oral antihyperglycemic agents, and not agreeing to begin insulin therapy.
MATERIAL AND METHODS. 21 patients, among them 6 women, aged between 46 and 90 years (mean 63.5 ± 10.4 years), suffering from type 2 diabetes from one year up to 22 years (mean 10.6 ± 5.6 years), treated with vildagliptin from 4 up to 22.5 months (mean 12.5 ± 6.0 months) were observed. Impact of vildagliptin treatment on metabolic control, weight, blood pressure value and hypoglycemia frequency was evaluated.
RESULTS. After vildagliptin was added to the therapy with two oral hypoglycemic drugs, HbA_1c level decreased significantly by 0.7% from 8.19 ± 0.77% at baseline to 7.49 ± 0.96% at the end of the study (p = 0.002). This improvement was maintained all along the observation. During vildagliptin treatment patient’s weight remained unchanged, diastolic blood pressure significantly decreased from 84.2 ± 9.8 mm Hg to 80.5 ± 7.5 mm Hg (p = 0.014), and trend towards systolic blood pressure reduction from 150.3 ± 23.0 mm Hg to 145.3 ± 17.0 mm Hg was also observed (p = 0.136). No patient experienced severe hypoglycemia episode, and also frequency of mild hypoglycemia didn’t increase.
CONCLUSIONS. Vildagliptin, despite lack of an official registration for use in the subjects with type 2 diabetes treated with two oral hypoglycemic drugs, appeared to be effective and safe alternative method of therapy intensification in a group of patients not achieving good glycemic control on such a treatment. (Diabet. Prakt. 2010; 11, 4: 153–159)