Date of Award

Winter 1-4-2019

Document Type

Dissertation

Degree Name

PharmD

Department

Department of Pharmacy Practice

First Advisor

Dr. Kavitha Saravu

Abstract

Background: Over the past few years, the use of dipeptidyl peptidase-4 (DPP-4) inhibitors in management of type 2 diabetes have increased as second to third line treatment. A recent study reported that the use of DPP-4 inhibitors may be associated with an increased risk of Inflammatory bowel disease (IBD). However, a meta-analysis showed conflicting results. Objectives:  To find association between DPP-4 inhibitors use and development of IBD in type 2 diabetic patients.  To find association between duration of DPP-4 inhibitors and development of IBD in type 2 diabetic patients.  To find association between duration of type 2 diabetes and development of IBD. Methods: A case control study was conducted in Kasturba Hospital for a period of 1 year. Case (IBD patients) and Control (Non-IBD patients) were selected based on inclusion and exclusion criteria of the study. The relevant information was collected from medical records using a suitably designed Case Report Form. SPSS version 20.0 was to perform statistical analysis. p<0.05 was considered significant for all the statistical analysis. Results: Case group contains 66 patients, of these, 28(42%) were female and 38(58%) were males. Similarly, control group also contains 66 with 42 % of females and 58% males. In control group, 9% each used Vildagliptin and Teneligliptin, followed by 3% Sitagliptin. In case group, 3% each used Vildagliptin and Linagliptin, followed by 2% Teneligliptin (2%). Out of the 19 subjects who were taking DPP-4 inhibitors, 5 (26.3%) subjects presented with IBD. There was a statistically significant difference in development of IBD after DPP-4 inhibitors use compared to non-DPP4 inhibitor group. But, the IBD occurrence was more among those who were not taking DPP-4 inhibitors (54%) compared to DPP-4 inhibitors group (26.3%). There was no statistically significant association (p = 1.00) in duration of DPP4 inhibitors use and development of IBD. Similarly, there was no significant association (p = 1.00) between duration of diabetes and development of IBD. Conclusion: In our study, there is a significant association in development of IBD with use of DPP-4 inhibitors. However, IBD occurrence was more in non DPP-4 inhibitors group. However, this study may need to be replicated in a larger population for a more conclusive result. Additionally, there were no association of duration of DPP-4 inhibitors use with development of IBD and similarly, the duration of diabetes with development of IBD.

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