Ali TAMER, Ceyhun VARIM, Tezcan KAYA, Ahmet NALBANT, Selçuk YAYLACI, Feyzi GÖKOSMANOĞLU, Perihan VARIM, Emine AKÇAY ÜLKÜ, Mehmet Şevki UYANIK, Mehmet Bülent VATAN

Yeni Tanı Tip 2 Diabetes Mellitus' lu hastalarda DPP-4 inhibitörlerinin HbA1c, Hematolojik ve İnflamasyon Parametreleri Üzerine Etkileri

Amaç: Sitagliptin ve vildagliptin ülkemizde son zamanlarda piyasaya sürülmüş Dipeptidil Peptidaz- 4 (DPP-4)inhibitörü oral antidiyabetik ajanlardır. Amerikan Diyabet Cemiyeti (ADA) 2014 diabetes mellitus (DM) tedavikılavuzuna göre metformin tedavisi ile kontrol altına alınamayan Tip 2 DM hastalarında 2.sıra tedavi olarak DPP-4inhibitörleri tercih edilebilir. Biz bu çalışmamızda metformin tedavisi ile yeterli glisemik kontrol sağlayamadığımızve tedaviye sitagliptin veya vildagliptin eklediğimiz hastalarda bu 2 ilacın inflamasyon ve kardiyovasküler riskiazaltmada daha etkili olduğunu hemogram parametreleri üzerinden ortaya koymaya çalıştık. Yöntem ve Gereçler: Kliniğimiz Diyabet Polikliniğinde takipli Tip 2 DM tanısı ile günde 2 doz 1000 mg. toplam2000 mg. metformin tedavisi alan ve metformin tedavisi ile yeterli kan şekeri regülasyonu sağlanamayıp tedaviyegünde tek doz 100 mg sitagliptin veya günde 2 doz 50 mg. toplam 100 mg. vildagliptin eklenen hastaların dosyalarıtarandı. Çalışmamızın dahil edilme ve dışlanma kriterlerine uyan 62 hasta tespit edildi. Hastalar metformin + sitag- liptin kullanan grup (Grup1) ve metformin + vildagliptin kullanan grup (Grup2) olarak ikiye ayrıldı. Bu 2 grubunmetformin tedavisine sitagliptin veya vildagliptin eklendiği andaki ve 6. ay sonundaki HbA1c, Vücut Kitle İndek- si (VKİ),beyaz küre sayımı (WBC), Nötrofil Lenfosit Oranı (NLR), Trombosit Lenfosit Oranı (PLR), OrtalamaTrombosit Hacimi (MPV) karşılaştırıldı Sitagliptin ve vildagliptin tedavilerinin bu parametreler üzerine etkileri vebiribirine üstünlükleri olup olmadığı araştırıldı.Bulgular: Metformin tedavisine sitagliptin eklenen (Grup 1) ile metformin tedavisine vildagliptin eklenen (Grup 2)demografik veriler açısından karşılaştırıldığında birbirine benzerdi (Tablo-1). Her 2 grupta 6 aylık tedavi sonundabenzer ve istatistiksel olarak anlamlı HbA1c ( grup1 p:

Effects of DPP-4 inhibitors on HbA 1c, haematological parameters , parameters of inflammation in the patients with newly diagnosed Type 2 DM

Aim: Diabetes mellitus is a chronic inflammatory disease characterized by high blood sugar levels. The aim of thepresent study was to investigate the efficacy of vildagliptin and sitagliptin as an add-on to metformin in suppressinginflammation. Material and Methods: A total of 62 patients with Type 2 Diabetes Mellitus using metformin were included thestudy. The patients were classified into the two groups. Group 1 sitagliptin add-on to metformin treatment. Group 2vildagliptin add-on to metformin treatment. Inflammatuar parameters such as, mean platelet volume (MPV), plateletto lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR) at the start of vildagliptin and sitagliptin treatmentand in the 6th month of treatment were compared. Results: There were no significant differences in sex and age between two groups (Table 1). Similar and statisti- cally significant reduction of HbA1c (group1 p:

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