Effect of Add-On Therapy of Sodium-Glucose Cotransporter 2 Inhibitors and Dipeptidyl Peptidase 4 Inhibitors on Adipokines in Type 2 Diabetes Mellitus

Abid Shaheer, Ashok Kumar, Palat Menon , Mahir Jallo, Shaikh Basha

Excess adiposity is associated with an increased risk of CVD due to metabolic changes in the body. Visceral obesity increases the risk of DM through adipocytokines and hence the effective targeting therapies are essential to control obesity in high-risk individuals. The study’s main objective was to evaluate the effect of SGLT2 inhibitors & DPP4 inhibitors on visceral fat-associated serum adipokines.

The study included 90 subjects diagnosed with T2DM. The blood samples were taken before starting first-line therapy with metformin, 12 weeks after starting metformin therapy and 12 weeks after beginning add-on therapy.

The mean adiponectin level was significantly elevated with add-on therapy using SGLT2 inhibitors and DPP4 inhibitors (P<0.001). The mean retinol-binding protein 4 (RBP4), fatty acid-binding protein 4 (FABP4) and visfatin levels were reduced considerably (P<0.001) with add-on therapy. The SGLT2 inhibitors are more effective on serum FABP4 in patients with T2DM (P=0.038). The mean FPG, PPBG and HbA1c levels were reduced significantly with add-on therapy (P<0.001). The lipid profile was also altered considerably with this add-on therapy (P<0.001).

The add-on therapy exerts a beneficial effect in T2DM insufficiently controlled with metformin by altering the visceral fat-associated adipokine levels and controlling the metabolic activities. Add-on therapy of both SGLT2 inhibitors and DPP4 inhibitors substantially affects RBP4, FABP4, adiponectin and visfatin in T2DM The study provides new insight into the effective therapeutic goal in central obese type 2 diabetic patients.

Integration Subspezialität Diabetes und Auge

Conflict of Interest

No Conflict of interest for all authors

Publication History

Article published online:
26 May 2022