Sitagliptin for prevention of stress hyperglycemia in patients without diabetes undergoing general surgery: A pilot randomized study.

Abstract

AIM:

We investigated if a dipeptidyl peptidase-4 inhibitor, sitagliptin, can prevent perioperative stress hyperglycemia in patients without prior history of diabetes mellitus undergoing general surgery.

METHODS:

This double-blind pilot trial randomized general surgery patients to receive sitagliptin (n = 44) or placebo (n = 36) once daily, starting one day prior to surgery and continued during the hospital stay. The primary outcome was occurrence of stress hyperglycemia, defined by blood glucose (BG) >140 mg/dL and >180 mg/dL after surgery. Secondary outcomes included: length-of-stay, ICU transfers, hypoglycemia, and hospital complications.

RESULTS:

BG >140 mg/dL was present in 44 (55%) of subjects following surgery. There were no differences in hyperglycemia between placebo and sitagliptin (56% vs. 55%, p = 0.93). BG >180 mg/dL was observed in 19% and 11% of patients treated with placebo and sitagliptin, respectively, p = 0.36. Both treatment groups had resulted in similar postoperative BG (148.9 ± 29.4 mg/dL vs. 146.9 ± 35.2 mg/dL, p = 0.73). There were no differences in length-of-stay (4 vs. 3 days, p = 0.84), ICU transfer (3% vs. 5%, p = 1.00), hypoglycemia <70 mg/dL (6% vs. 11%, p = 0.45), and complications (14% vs. 18%, p = 0.76).

CONCLUSION:

Preoperative treatment with sitagliptin did not prevent stress hyperglycemia or complications in individuals without diabetes undergoing surgery.

• Authors: Maya Fayfman, Georgia Davis, Elizabeth W Duggan, Maria Urrutia, David Chachkhiani, Joanna Schindler, Francisco J Pasquel, Rodolfo J Galindo, Priyathama Vellanki, David Reyes-Umpierrez, Heqiong Wang, Guillermo E Umpierrez
• Journal: Journal of diabetes and its complications (J Diabetes Complications) Vol. 32 Issue 12 Pg. 1091-1096 (Dec 2018) ISSN: 1873-460X [Electronic] United States
• PMID: 30253968 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Published by Elsevier Inc.

Chemical References

• Blood Glucose
• Dipeptidyl-Peptidase IV Inhibitors
• Sitagliptin Phosphate

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Blood Glucose (drug effects, metabolism)
• Dipeptidyl-Peptidase IV Inhibitors (therapeutic use)
• Double-Blind Method
• Feasibility Studies
• Female
• Hospitalization
• Humans
• Hyperglycemia (etiology, prevention & control)
• Male
• Middle Aged
• Pilot Projects
• Preoperative Care (methods)
• Sitagliptin Phosphate (therapeutic use)
• Stress, Psychological (blood, complications, drug therapy)
• Surgical Procedures, Operative (adverse effects, psychology)
• Young Adult