ABSTRACT
Objective:
The occurrence of partial remission (honeymoon phase) in type 1 diabetes (T1D) has been associated with a reduced risk of chronic microvascular complications of diabetes. We have published case reports showing that a combination therapy with the DPP-4 inhibitor sitagliptin plus vitamin D3 (VIDPP-4i) can prolong the honeymoon phase in patients with new-onset T1D. In the present case-control study, we investigated the frequency of occurrence of clinical remission (CR) in patients with new-onset T1D after VIDPP-4i treatment.
Subjects and methods:
In this case-control study, we collected data spanning 10 years from medical records of 46 patients (23 females) recently diagnosed with T1D. Overall, 27 participants with CR (insulin dose-adjusted glycated hemoglobin [IDAA1c] ≤ 9) at 12 or 24 months composed the case group, and 19 participants without CR served as the control group. Chi-square with Yates correction was used to analyze the association between VIDPP-4i use and CR, and odds ratio (OR) was used to determine the chance of CR due to VIDPP-4i treatment exposure.
Results:
In all, 37 patients (80.4%) experienced CR at some time over 24 months. The mean CR duration was 13.15 ± 9.91 months. Treatment with VIDPP-4i was significantly associated with CR. At 24 months, the OR of CR after VIDPP-4i exposure was 9.0 (95% confidence interval [CI] 2.21-30.18, p = 0.0036). Additionally, 9 (33.6%) and 4 (14.8%) patients in the VIDPP-4i group experienced insulin-free CR at 12 and 24 months, respectively.
Conclusion:
Therapy with VIDPP-4i was associated with a higher frequency and duration of the honeymoon phase. Randomized controlled trials are needed to confirm these findings.
Keywords: cholecalciferol; DPP-4 inhibitor; honeymoon phase; Type 1 diabetes; Vitamin D
PINHEIRO, Marcelo Maia; PINHEIRO, Felipe Moura Maia; ARRUDA, Marcelo Müller de; BEATO, Geane Moron; VERDE, Graciele Alves Corrêa Lima; BIANCHINI, Georgiana; CASALENUOVO, Pedro Rosário Moraes; ARGOLO, Aline Aparecida Agostini; SOUZA,Lucilene Telles de; PESSOA, Flávia Gomes; HIROSE, Thiago Santos; SENRA, Eduardo Filgueiras; RICORDI, Camillo; FABBRI,Andrea; INFANTE, Marco; DINIZ, Susana Nogueira. Association between sitagliptin plus vitamin D3 (VIDPP-4i) use and clinical remission in patients with new-onset type 1 diabetes: a retrospective case-control study. Arch. Endocrinol. Metab., v. 67, n. 5, e000652, May. 2023