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Below 70? The 15-15 rule

All forDiabetes

Sitagliptin improved dipeptidyl peptidose – IV activity and glucagons – like peptide – 1 in obese

All for DiabetesPublished October 1, 20062 min read

Key points

  • Sitagliptin inhibited plasma dipeptidyl peptidose-IV activity and increased glucagons-like peptide-1 in nondiabetic obese subjects.
  • Herman and colleagues at Merck Research Laboratories explained, “Middle-aged (45-63 years), nondiabetic, obese (body mass index: 30-40 kg/m2) men and women were randomized to sitagliptin 200 mg bid (n=24) or placebo (n=8) for 28 days.”
  • The researchers concluded, “In nondiabetic obese subjects, treatment with sitagliptin 200 mg bid was generally well tolerated without associated hypoglycemia and led to maximal inhibition of plasma DPP-4 activity, increased active GLP-1, and reduced glycemic excursion.”
  • The publisher of the Journal of Clinical Pharmacology can be contacted at: Sage Publications Inc., 2455 Teller Rd., Thousand Oaks, CA 91320, USA.

Sitagliptin inhibited plasma dipeptidyl peptidose-IV activity and increased glucagons-like peptide-1 in nondiabetic obese subjects.

“Sitagliptin (MK-0431) is an oral, potent, and selective dipeptidyl peptidose-IV (DPP-4) inhibitor developed for the treatment of type 2 diabetes. This multicenter, randomized, double-blind, placebo-controlled study examined the pharmacokinetic and pharmacodynamic effects of sitagliptin in obese subjects,” investigators in the United States report.

G.A. Herman and colleagues at Merck Research Laboratories explained, “Middle-aged (45-63 years), nondiabetic, obese (body mass index: 30-40 kg/m2) men and women were randomized to sitagliptin 200 mg bid (n=24) or placebo (n=8) for 28 days.”

The investigators discovered, “Steady-state plasma concentrations of sitagliptin were achieved within 2 days of starting treatment, and >90% of the dose was excreted unchanged in urine. Sitagliptin treatment led to similar to 90% inhibition of plasma DPP-4 activity, increased active glucagon-like peptide-1 (GLP-1) levels by 2.7-fold (p<0.001), and decreased postoral glucose tolerance test glucose excursion by 35% (p<0.050) compared to placebo."

The researchers concluded, “In nondiabetic obese subjects, treatment with sitagliptin 200 mg bid was generally well tolerated without associated hypoglycemia and led to maximal inhibition of plasma DPP-4 activity, increased active GLP-1, and reduced glycemic excursion.”

Herman and colleagues published their study in the Journal of Clinical Pharmacology (Pharmacokinetics and pharmacodynamic effects of the oral DPP-4 inhibitor sitagliptin in middle-aged obese subjects. J Clin Pharmacol, 2006;46(8):876-886).

For additional information, contact G.A. Herman, Merck Research Laboratories, RY34-A536, 126 E Lincon Avenue, Rahway, NJ 07065, USA.

The publisher of the Journal of Clinical Pharmacology can be contacted at: Sage Publications Inc., 2455 Teller Rd., Thousand Oaks, CA 91320, USA.

The content on this site is for information only and is not a substitute for professional medical advice, diagnosis or treatment. If someone with diabetes is confused, unconscious or cannot swallow, call 911 or your local emergency number.

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Low blood sugar

Below 70? Use the 15-15 rule.

Hypoglycemia can happen to anyone who takes insulin or certain diabetes tablets. Treat it straight away. If someone is confused, unconscious or can’t swallow, don’t give food or drink: use glucagon if it is available and call 911 or your local emergency number.

Common signs

  • Shaking or trembling
  • Sweating, clammy skin
  • Fast heartbeat
  • Dizziness
  • Hunger
  • Confusion or irritability
  1. STEP 115 gTake fast-acting sugar4 oz (½ cup) of juice or regular soda, 4 glucose tablets, or 1 tablespoon of sugar or honey.
  2. STEP 215 minWait, then recheckStill below 70 mg/dL? Take another 15 g and check again.
  3. STEP 3SnackOnce back in rangeEat a meal or snack if your next one is more than an hour away.

Based on American Diabetes Association guidance. Your care team may give you a different plan, for example for children or after severe lows. Outside the US, call your local emergency number.