Publication:

Efficacy of teneligliptin in type 2 diabetes mellitus

Background Teneligliptin is a novel, highly selective dipeptidyl peptidase-4 (DPP-4) inhibitor. The aim of the study was to assess the effectiveness of Metformin in combination with teneligliptin in Indian patients with type 2 diabetes mellitus who were inadequately controlled with metformin monotherapy.

Methods Patients with glycated haemoglobin (HbA1c) of 7.0–10.0% and on metformin upto 1000 mg/day were selected for the study. 130 Known diabetic patients were selected, out of which only 56 patients were eligible as per the criteria. these patients were randomly divided into two groups, group A comprises 28 patients whose baseline FBS, PPBS, Hba1c was determined and the patients were put on teneligliptin 20 mg per day apart from metformin 1gm /day, Group B comprises of 28 patients whose baseline FBS, PPBS, Hba1c were determined and these patients were already on metformin 500mg-1gm per day but there glycemic control was poor, all these patients in group b received an escalation of Metformin dose upto 2.5gm/day, to achieve glycemic control and patients were monitored closely with proper diabetic diet counselling.

Results The mean baseline HbA1c in teneligliptin group was 8.23% when compared to 8.07% in the Metformin group. The primary endpoint of the study was to monitor the changes in HbA1c levels from baseline to week 30. It was observed that the mean HbA1c for teneligliptin group after 30 weeks was 7.21% versus 7.63% in metformin group. HbA1c was significantly reduced in the Group A patients.

Conclusions In conclusion, the addition of teneligliptin to metformin treatment was effective and well tolerated in patients with type 2 diabetes. Teneligliptin has long half-life of 26.9 hours along with it also has a unique pharmacokinetic advantage which allows convenient once daily administration irrespective of food, superadded it has a dual mode of elimination via renal and hepatic, and hence can be administered safely in renal impairment patients. In mild to moderate hepatic impairment no dosage adjustment is required. The appropriate approach towards managing diabetes should be not only glycemic control but also preservation of islet cell function early and to delay progression of a disease. Teneligliptin add-on to Metformin during the early course of treatment helps in delaying the exhaustion of pancreatic islet function.