Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery

Aims To determine if treatment with sitagliptin, a dipeptidyl peptidase-4 inhibitor, can prevent stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery.Methods We conducted a pilot, double-blinded, placebo-controlled randomized trial in adults (18–80...

Full description

Saved in:
Bibliographic Details
Main Authors: Saumeth Cardona, Priyathama Vellanki, Maya Fayfman, Rodolfo J Galindo, Francisco J Pasquel, Katerina Tsegka, Limin Peng, Sol Jacobs, Michael Halkos, Robert A Guyton, Vinod H Thourani, Guillermo Umpierrez
Format: Article
Language:English
Published: BMJ Publishing Group 2019-05-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/7/1/e000703.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850256124118302720
author Saumeth Cardona
Priyathama Vellanki
Maya Fayfman
Rodolfo J Galindo
Francisco J Pasquel
Katerina Tsegka
Limin Peng
Sol Jacobs
Michael Halkos
Robert A Guyton
Vinod H Thourani
Guillermo Umpierrez
author_facet Saumeth Cardona
Priyathama Vellanki
Maya Fayfman
Rodolfo J Galindo
Francisco J Pasquel
Katerina Tsegka
Limin Peng
Sol Jacobs
Michael Halkos
Robert A Guyton
Vinod H Thourani
Guillermo Umpierrez
author_sort Saumeth Cardona
collection DOAJ
description Aims To determine if treatment with sitagliptin, a dipeptidyl peptidase-4 inhibitor, can prevent stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery.Methods We conducted a pilot, double-blinded, placebo-controlled randomized trial in adults (18–80 years) without history of diabetes. Participants received sitagliptin or placebo once daily, starting the day prior to surgery and continued for up to 10 days. Primary outcome was differences in the frequency of stress hyperglycemia (blood glucose (BG) >180 mg/dL) after surgery among groups.Results We randomized 32 participants to receive sitagliptin and 28 to placebo (mean age 64±10 years and HbA1c: 5.6%±0.5%). Treatment with sitagliptin resulted in lower BG levels prior to surgery (101±mg/dL vs 107±13 mg/dL, p=0.01); however, there were no differences in the mean BG concentration, proportion of patients who developed stress hyperglycemia (21% vs 22%, p>0.99), length of hospital stay, rate of perioperative complications and need for insulin therapy in the intensive care unit or during the hospital stay.Conclusion The use of sitagliptin during the perioperative period did not prevent the development of stress hyperglycemia or need for insulin therapy in patients without diabetes undergoing CABG surgery.
format Article
id doaj-art-84fcff3743514cd6b09b39e428c2d33c
institution OA Journals
issn 2052-4897
language English
publishDate 2019-05-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open Diabetes Research & Care
spelling doaj-art-84fcff3743514cd6b09b39e428c2d33c2025-08-20T01:56:42ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972019-05-017110.1136/bmjdrc-2019-000703Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgerySaumeth Cardona0Priyathama Vellanki1Maya Fayfman2Rodolfo J Galindo3Francisco J Pasquel4Katerina Tsegka5Limin Peng6Sol Jacobs7Michael Halkos8Robert A Guyton9Vinod H Thourani10Guillermo Umpierrez11Medicine, Emory University School of Medicine, Atlanta, Georgia, USADepartent of Medicine, Emory University, Atlanta, Georgia, USAMedicine, Emory University School of Medicine, Atlanta, Georgia, USADivision of Endocrinology, Diabetes, and Metabolism, University of Miami Miller School of Medicine, Miami, Florida, USAMedicine, Emory University School of Medicine, Atlanta, Georgia, USAMedicine, Emory University School of Medicine, Atlanta, Georgia, USADepartent of Medicine, Emory University, Atlanta, Georgia, USAMedicine, Emory University School of Medicine, Atlanta, Georgia, USAThoracic Surgery, Emory University School of Medicine, Atlanta, Georgia, USAThoracic Surgery, Emory University School of Medicine, Atlanta, Georgia, USAThoracic Surgery, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Medicine, Emory University, Atlanta, Georgia, USAAims To determine if treatment with sitagliptin, a dipeptidyl peptidase-4 inhibitor, can prevent stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery.Methods We conducted a pilot, double-blinded, placebo-controlled randomized trial in adults (18–80 years) without history of diabetes. Participants received sitagliptin or placebo once daily, starting the day prior to surgery and continued for up to 10 days. Primary outcome was differences in the frequency of stress hyperglycemia (blood glucose (BG) >180 mg/dL) after surgery among groups.Results We randomized 32 participants to receive sitagliptin and 28 to placebo (mean age 64±10 years and HbA1c: 5.6%±0.5%). Treatment with sitagliptin resulted in lower BG levels prior to surgery (101±mg/dL vs 107±13 mg/dL, p=0.01); however, there were no differences in the mean BG concentration, proportion of patients who developed stress hyperglycemia (21% vs 22%, p>0.99), length of hospital stay, rate of perioperative complications and need for insulin therapy in the intensive care unit or during the hospital stay.Conclusion The use of sitagliptin during the perioperative period did not prevent the development of stress hyperglycemia or need for insulin therapy in patients without diabetes undergoing CABG surgery.https://drc.bmj.com/content/7/1/e000703.full
spellingShingle Saumeth Cardona
Priyathama Vellanki
Maya Fayfman
Rodolfo J Galindo
Francisco J Pasquel
Katerina Tsegka
Limin Peng
Sol Jacobs
Michael Halkos
Robert A Guyton
Vinod H Thourani
Guillermo Umpierrez
Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery
BMJ Open Diabetes Research & Care
title Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery
title_full Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery
title_fullStr Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery
title_full_unstemmed Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery
title_short Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery
title_sort sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft cabg surgery
url https://drc.bmj.com/content/7/1/e000703.full
work_keys_str_mv AT saumethcardona sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT priyathamavellanki sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT mayafayfman sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT rodolfojgalindo sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT franciscojpasquel sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT katerinatsegka sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT liminpeng sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT soljacobs sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT michaelhalkos sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT robertaguyton sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT vinodhthourani sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery
AT guillermoumpierrez sitagliptinforthepreventionofstresshyperglycemiainpatientswithoutdiabetesundergoingcoronaryarterybypassgraftcabgsurgery