TITLE:
The Efficacy and Safety of Saxagliptin in Haemodialysis Patients
AUTHORS:
Abdul Halim Abdul Gafor, Azrina Abdul Kadir, Rizna Abdul Cader, Rozita Mohd, Kong Wei Yen, Rohana Abdul Ghani, Shamsul Azhar Shah, Norella C. T. Kong
KEYWORDS:
Fructosamine; Fasting Blood Sugar; HbA1c; Haemodialysis; Saxagliptin; Type 2 Diabetes Mellitus
JOURNAL NAME:
Open Journal of Nephrology,
Vol.3 No.2,
June
4,
2013
ABSTRACT: Introduction: Good glycaemic control without causing
excessive hypoglycaemia reduced the risk of macrovascular and microvascular
complications in type 2 DM patients on regular haemodialysis (HD). The
objectives of this study were to assess the efficacy and safety of add-on saxagliptin to insulin
therapy in blood sugar control compared to insulin therapy alone in diabetic
patients undergoing HD. Design and Methods: In this prospective open-labelled randomized
controlled trial, HD patients with type 2 DM and on stable insulin therapy with
HbA1c 7% - 13% were randomized to receive add-on
saxagliptin 2.5 mg once daily to insulin therapy or insulin therapy only for 12
weeks. Results: 24 patients were randomized into each arm equally. Baseline and week-12
serum HbA1c, fructosamine, fasting blood glucose (FBS) and mean self monitoring
blood glucose (SMBG) were comparable in the groups. Reduction of HbA1c and mean
SMBG were significant in both groups. There was a significant drop in fructosamine levels (p = 0.004) and trend of lower FBS (p = 0.097) in add-on saxagliptin group but not in insulin alone group. The
incidence of hypoglycaemia was the same in both groups. Conclusion: Add-on saxagliptin to insulin
is comparable to insulin therapy alone in blood sugar control in regular HD
patients and is safe and generally well tolerated. Add-on saxagliptin group may have more persistent and
less fluctuation of glucose control compared to insulin only group.