Tuesday, July 3, 2012

Diabetes medication reduces inflammation

Inflammation contributes to the development of atherosclerosis .  A study abstract posted on " NTK Watch" today demonstrates that, Sitaglipitin ( Januvia )  reduces known markers of inflammation along with its glucose lowering effect .
Metformin , is everyones first choice when medication is needed for treatment of Type 2 Diabetes. This study will help move Sitagliptin up the ladder in choosing the second place medication.

Have Fun , Be Smart  , know and understand your diabetes treatment options
David Calder,MD
Tomorrow , understanding  GLP-1 agonist ( glucagon- like peptide -1) and DPP-IV inhibitors

 2012 Jun 28. [Epub ahead of print]

Sitagliptin Exerts an Antinflammatory Action.


Division of Endocrinology, Diabetes, and Metabolism, State University of New York at Buffalo, and Kaleida Health, Buffalo, New York 14209.


Context:Sitagliptin is an inhibitor of the enzyme dipeptidyl peptidase-IV (DPP-IV), which degrades the incretins, glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide, and thus, sitagliptin increases their bioavailability. The stimulation of insulin and the suppression of glucagon secretion that follow exert a glucose lowering effect and hence its use as an antidiabetic drug. Because DPP-IV is expressed as CD26 on cell membranes and because CD26 mediates proinflammatory signals, we hypothesized that sitagliptin may exert an antiinflammatory effect.Patients and Methods:Twenty-two patients with type 2 diabetes were randomized to receive either 100 mg daily of sitagliptin or placebo for 12 wk. Fasting blood samples were obtained at baseline and at 2, 4, and 6 hours after a single dose of sitagliptin and at 2, 4, 8, and 12 wk of treatment.Results:Glycosylated hemoglobin fell significantly from 7.6 ± 0.4 to 6.9 ± 3% in patients treated with sitagliptin. Fasting glucagon-like peptide-1 concentrations increased significantly, whereas the mRNA expression in mononuclear cell of CD26, the proinflammatory cytokine, TNFα, the receptor for endotoxin, Toll-like receptor (TLR)-4, TLR-2, and proinflammatory kinases, c-Jun N-terminal kinase-1 and inhibitory-κB kinase (IKKβ), and that of the chemokine receptor CCR-2 fell significantly after 12 wk of sitagliptin. TLR-2, IKKβ, CCR-2, and CD26 expression and nuclear factor-κB binding also fell after a single dose of sitagliptin. There was a fall in protein expression of c-Jun N-terminal kinase-1, IKKβ, and TLR-4 and in plasma concentrations of C-reactive protein, IL-6, and free fatty acids after 12 wk of sitagliptin.Conclusions:These effects are consistent with a potent and rapid antiinflammatory effect of sitagliptin and may potentially contribute to the inhibition of atherosclerosis. The suppression of CD26 expression suggests that sitagliptin may inhibit the synthesis of DPP-IV in addition to inhibiting its action.
[PubMed - as supplied by publisher]


  1. Usually the benefits of the medicine are more important than any minor side effects. So i suggest Metformin for Treatment of Diabetes Type 2.

  2. Thanks for your comment. Dr. Calder

  3. The question is will it work the other way around. As in if someone goes to order nasonex, will it help combat diabetes as well as inflammation?

  4. Good question . Steroids in general interfere with glucose metabolism and make diabetes management more difficult. Nasonex is a low dose steroid , when taken as recommended , will have will have no significant impact on glucose control. Please see the Jan. 13 ,2013 post for more on steroids and diabetes .Dr. Calder

  5. Has there been any serious adverse effects observed after taking in this drug? It seems too good to have no side effects, considering it can reduce both glucose levels and joint inflammation.


Your comments and questions are appreciated. David Calder,MD