Obvladovanje sladkorne bolezni tipa 2 z zaviralci dipeptidil-peptidaze IV (DPP IV/CD26) – sistematični pregled kliničnih študij

Milevoj, Massima (author), Jeras, Matjaž (mentor), Batičić, Lara (comentor)

Sladkorna bolezen tipa 2 je kronična presnovna motnja, za katero sta značilni vztrajna hiperglikemija in inzulinska rezistenca, ki predstavlja velik svetovni zdravstveni izziv. Zaviralci DPP IV/CD26 so se izkazali za dragoceno možnost zdravljenja, saj zagotavljajo učinkovito uravnavanje glikemije z minimalnimi stranskimi učinki. Namen diplomske naloge je opraviti sistematičen pregled kliničnih študij, osredotočenih na obvladovanje sladkorne bolezni tipa 2 z zaviralci DPP IV/CD26 v kombinaciji z metforminom v primerjavi s konvencionalno monoterapijo z metforminom, pri čemer se osredotoča na dokaze iz objavljenih kliničnih študij. Izvedli smo sistematičen pregled v skladu s smernicami PRISMA in pridobili baze podatkov PubMed in Web of Science. Analizirali smo kakovost izbranih študij, objavljenih med letoma 2014 in 2024, s pomočjo kontrolnih seznamov CASP in jih primerjali glede na leto objave, državo izvora, število udeležencev in zaviralec DPP IV/CD26, uporabljen za zdravljenje. Ocenili smo tudi učinkovitost kombiniranega zdravljenja z metforminom v primerjavi z metforminom samim na podlagi razlike v znižanju HbA1c. Začetni nabor 689 študij smo zožili na 4 ustrezne, ki so bile usklajene z raziskovalnim vprašanjem in so vsebovale rezultate, pomembne za temo pregleda. Identificirali smo koristi zaviralca DPP IV/CD26 kot dela kombinirane terapije z metforminom pri bolnikih s sladkorno boleznijo tipa 2. Kombinirano zdravljenje z DPP IV/CD26 in metforminom se je izkazalo za učinkovitejše od konvencionalnega zdravljenja z metforminom. Uporaba zaviralcev DPP IV/CD26 je povzročila blažje in manj pogoste neželene učinke v primerjavi z monoterapijo z metforminom. Dodatek teh zaviralcev običajni monoterapiji z metforminom je pozitivno vplival na ravni HbA1c. Rezultati kažejo, da uporaba zaviralcev DPP IV/CD26 izboljša glikemični odziv, pri čemer sta varnost in profil prenašanja boljši v primerjavi s profilom metformina.

• Language: Slovenian
• Keywords: sladkorna bolezen tipa 2, hiperglikemija, normoglikemija, encim DPP IV/CD26, zaviralci DPP IV/CD26, klinične študije
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2025
• PID: 20.500.12556/RUL-167983
• Publication date in RUL: 22.03.2025

Secondary language

• Language: English
• Title: Type 2 diabetes management with dipeptidyl-peptidase IV inhibitors (DPP IV/CD26) - A systematic review of clinical studies

Abstract

Type 2 diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycaemia and insulin resistance, posing significant global health challenges. Dipeptidyl – peptidase IV/Cluster of Differentiation 26 (DPP IV/CD26) inhibitors have proven to be a valuable treatment option, providing effective glycaemic management with minimal side effects The aim of this thesis is to perform a systematic review of clinical studies focused on the management of type 2 diabetes with DPP IV/CD26 inhibitors combined with metformin compared to conventional metformin monotherapy. We performed a systematic review following PRISMA guidelines sourcing PubMed and Web of Science databases. We analysed the quality of selected studies published between 2014 and 2024 using the CASP checklists and compared them based on the year of publication, country of origin, number of participants, and the DPP IV/CD26 inhibitor used for the treatment. We also evaluated the efficacy of the combination therapy with metformin, compared to metformin alone based on the difference in HbA1c reduction. We narrowed down the initial set of 689 studies to 4 appropriate ones that aligned with the research question and contained results relevant to the review topic. The combination therapy with DPP IV/CD26 and metformin has been shown to be more efficient than the conventional metformin therapy for type 2 diabetes patients. The addition of DPP IV/CD26 inhibitors to conventional metformin monotherapy positively impacted HbA1c levels and caused milder and less frequent adverse events compared to metformin monotherapy. Results showed a greater reduction in HbA1c with DPP IV/CD26 and metformin combination therapy than with metformin monotherapy, with three studies reporting statistically significant differences. According to our results, the therapy with DPP IV/CD26 inhibitors in combination with metformin was proven to be more efficient and well-tolerated in comparation with metformin monotherapy.

• Keywords: type 2 diabetes, hyperglycaemia, normoglycemia, DPP IV/CD26 enzyme, DPP IV/CD26 inhibitors, clinical studies