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Management of patients with type 2 diabetes and mild/moderate renal impairment: profile of linagliptin

Authors Gallwitz B

Received 27 March 2015

Accepted for publication 15 April 2015

Published 14 May 2015 Volume 2015:11 Pages 799—805

DOI https://doi.org/10.2147/TCRM.S67076

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Garry Walsh

Baptist Gallwitz

Department of Medicine IV, Eberhard-Karls University, Tübingen, Germany

Abstract: Dipeptidyl-peptidase-IV (DPP-4) inhibitors are oral antidiabetic agents that can be administered as monotherapy in patients with contraindications to metformin or metformin intolerance, and in combination with other oral compounds and/or insulin. DPP-4 inhibitors act in a glucose-dependent manner and only increase insulin secretion and inhibit glucagon secretion under hyperglycemic conditions. Renal impairment is frequent in type 2 diabetes as a result of microvascular complications and diabetes treatment, and options in these patients are limited. Linagliptin is a DPP-4 inhibitor with a hepatobiliary route of elimination. In comparative studies, it was noninferior to metformin and sulfonylureas in lowering glycated hemoglobin (HbA1c) and improving glycemic parameters. It can be used throughout all stages of renal impairment without dose adjustments. This review gives an overview of linagliptin in various stages of chronic kidney disease and has a focus on efficacy and safety parameters from clinical studies in patients with impaired renal function. These data are interpreted in the context of type 2 diabetes therapy in general.

Keywords: type 2 diabetes, renal impairment, oral antidiabetic drugs, incretin based therapies, DPP-4 inhibitors, linagliptin

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