FELIPE M. Pinheiro, Brazil
UNIC - CUIABÁ UNIVERSITY MEDICINEPresenter of 1 Presentation
PROLONGING THE HONEYMOON PHASE IN T1DM WITH SITAGLIPTIN PLUS VITAMIN D3
Abstract
Background and Aims
The preservation of the reserve of beta cells in new-onset T1DM by immunomodulation in addition to the incretin effect seems to be possible with an association of DPP-4i and vitamin D3. DPP-4i due to their anti-inflammatory and immunomodulating effects and increase GLP-1, have protective effects on beta cells.Vitamin D also has beneficial actions in insulin synthesis, secretion, and sensitivity.The aim this work is reporting the effects of the association sitagliptin plus vitamin D3 to prolong the ¨honeymoon phase¨ in new-onset T1D.
Methods
12 patients with new-onset T1D, 7 women, median age 15 y (6-39), median diabetes 12 months (6-100), undergoing treatment with sitagtliptin 100 mg plus vitamin D3 5,000 IU were evaluated their time in remission, C-peptide levels, evolution of HbA1c and insulin dose. We used IDAA1C (insulin dose-adjusted A1C) as the remission criterion. IDAA1C = A1C (percent) + [4 x insulin dose (UI/kg/24 h)]. A IDAA1C <= 9 indicates remission. All patients or their parents signed a consent form and the data analysis was approved by the UNIVAG Ethics Committee.
Results
BMI was 18,7 kg/m2 (+/- 3,2), 6 patients had KAD, median honeymoon time was 10 months (6-87), final mean insulin dose was 0,15 IU/kg/24 h (+/-0,24), 5 patients are without insulin (6-87 months), mean IDAA1C was 6,75 (+/-1,1), initial HbA1c was 11,69% (+/-2) and final HbAc1c was 5,59% (+/-1,88). Fasting initial C-peptide was 0,86 ng/dl (+/-0,47) and final C peptide was 0,89 ng/dl (+/-0,57)
Conclusions
Honeymoon phase prolongation in T1DM is possible with sitagliptin plus vitamin D3, even without insulin for 87 months.