The effects of vildagliptin on glycemic variability in patients with type 2 diabetes on premixed insulin therapy

AimPatients on premixed insulin therapy usually have poor glycemic control. This study aimed to investigate the effect of vildagliptin in these patients.MethodsThis real-world study included patients with type 2 diabetes mellitus (T2DM), who were poorly glycemic controlled on premixed insulin therap...

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Main Authors: Deyue Kong, Ziyang Shen, Lanlan Jiang, Xiaojing Xie, Rengna Yan, Ting Jing, Yun Hu, Jianhua Ma
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1508918/full
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author Deyue Kong
Ziyang Shen
Lanlan Jiang
Xiaojing Xie
Rengna Yan
Ting Jing
Yun Hu
Jianhua Ma
author_facet Deyue Kong
Ziyang Shen
Lanlan Jiang
Xiaojing Xie
Rengna Yan
Ting Jing
Yun Hu
Jianhua Ma
author_sort Deyue Kong
collection DOAJ
description AimPatients on premixed insulin therapy usually have poor glycemic control. This study aimed to investigate the effect of vildagliptin in these patients.MethodsThis real-world study included patients with type 2 diabetes mellitus (T2DM), who were poorly glycemic controlled on premixed insulin therapy and were subsequently added vildagliptin. The control group consisted of patients who only had their insulin doses adjusted without adding vildagliptin, matched for age, diabetic duration, HbA1c, and BMI. All patients underwent FGM, glycated hemoglobin(HbA1c), and glycated albumin(GA) measurements at baseline and three months after the treatment adjustment.ResultsPatients receiving vildagliptin treatment demonstrated significant reductions in HbA1c and GA levels (P<0.001 and P=0.009, respectively). The vildagliptin group exhibited a remarkable decrease in the mean amplitude of glycemic excursion (MAGE) (8.58 ± 0.36 vs. 6.62 ± 0.47, P<0.001), along with notable reductions in mean blood glucose (MBG) (10.7 ± 0.34 vs. 8.82 ± 0.39, P<0.001) and time above the target range (TAR) (52.60 ± 3.44 vs. 31.59 ± 4.31, P<0.001) compared to the control group. Moreover, there were notable improvements in the duration spent within the target range (TIR) (45.64 ± 3.33 vs. 64.22 ± 4.00, P<0.001), along with increases in the areas under the curve (AUC) for blood glucose levels above 4.4 (426.82 ± 83.19 vs. 892.16 ± 185.27, P=0.018) and 3.9 (213.81 ± 47.20 vs. 454.77 ± 103.21, P=0.029). Hourly mean blood glucose levels over a 2-week period monitored by FGM indicated lower blood glucose levels in the vildagliptin group, particularly after dinner (P=0.022).ConclusionVildagliptin added to premixed insulin effectively lowers blood glucose levels and reduces glycemic variability in patients with type 2 diabetes mellitus.Clinical Trial Registrationhttps://clinicaltrials.gov, identifier NCT04847219.
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spelling doaj-art-9f98de7e52034160a7586ca75ff5a0702025-08-20T03:21:40ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-06-011610.3389/fendo.2025.15089181508918The effects of vildagliptin on glycemic variability in patients with type 2 diabetes on premixed insulin therapyDeyue Kong0Ziyang Shen1Lanlan Jiang2Xiaojing Xie3Rengna Yan4Ting Jing5Yun Hu6Jianhua Ma7Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Endocrinology, the Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, ChinaDepartment of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaAimPatients on premixed insulin therapy usually have poor glycemic control. This study aimed to investigate the effect of vildagliptin in these patients.MethodsThis real-world study included patients with type 2 diabetes mellitus (T2DM), who were poorly glycemic controlled on premixed insulin therapy and were subsequently added vildagliptin. The control group consisted of patients who only had their insulin doses adjusted without adding vildagliptin, matched for age, diabetic duration, HbA1c, and BMI. All patients underwent FGM, glycated hemoglobin(HbA1c), and glycated albumin(GA) measurements at baseline and three months after the treatment adjustment.ResultsPatients receiving vildagliptin treatment demonstrated significant reductions in HbA1c and GA levels (P<0.001 and P=0.009, respectively). The vildagliptin group exhibited a remarkable decrease in the mean amplitude of glycemic excursion (MAGE) (8.58 ± 0.36 vs. 6.62 ± 0.47, P<0.001), along with notable reductions in mean blood glucose (MBG) (10.7 ± 0.34 vs. 8.82 ± 0.39, P<0.001) and time above the target range (TAR) (52.60 ± 3.44 vs. 31.59 ± 4.31, P<0.001) compared to the control group. Moreover, there were notable improvements in the duration spent within the target range (TIR) (45.64 ± 3.33 vs. 64.22 ± 4.00, P<0.001), along with increases in the areas under the curve (AUC) for blood glucose levels above 4.4 (426.82 ± 83.19 vs. 892.16 ± 185.27, P=0.018) and 3.9 (213.81 ± 47.20 vs. 454.77 ± 103.21, P=0.029). Hourly mean blood glucose levels over a 2-week period monitored by FGM indicated lower blood glucose levels in the vildagliptin group, particularly after dinner (P=0.022).ConclusionVildagliptin added to premixed insulin effectively lowers blood glucose levels and reduces glycemic variability in patients with type 2 diabetes mellitus.Clinical Trial Registrationhttps://clinicaltrials.gov, identifier NCT04847219.https://www.frontiersin.org/articles/10.3389/fendo.2025.1508918/fullvildagliptintype 2 diabetes mellitusglycemic excursionflash glucose monitoringpremixed insulin
spellingShingle Deyue Kong
Ziyang Shen
Lanlan Jiang
Xiaojing Xie
Rengna Yan
Ting Jing
Yun Hu
Jianhua Ma
The effects of vildagliptin on glycemic variability in patients with type 2 diabetes on premixed insulin therapy
Frontiers in Endocrinology
vildagliptin
type 2 diabetes mellitus
glycemic excursion
flash glucose monitoring
premixed insulin
title The effects of vildagliptin on glycemic variability in patients with type 2 diabetes on premixed insulin therapy
title_full The effects of vildagliptin on glycemic variability in patients with type 2 diabetes on premixed insulin therapy
title_fullStr The effects of vildagliptin on glycemic variability in patients with type 2 diabetes on premixed insulin therapy
title_full_unstemmed The effects of vildagliptin on glycemic variability in patients with type 2 diabetes on premixed insulin therapy
title_short The effects of vildagliptin on glycemic variability in patients with type 2 diabetes on premixed insulin therapy
title_sort effects of vildagliptin on glycemic variability in patients with type 2 diabetes on premixed insulin therapy
topic vildagliptin
type 2 diabetes mellitus
glycemic excursion
flash glucose monitoring
premixed insulin
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1508918/full
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