American Journal of Medicine, internal medicine, medicine, health, healthy lifestyles, cancer, heart disease, drugs

Dipeptidyl Peptidase-4 Inhibitors, Peripheral Arterial Disease, and Lower Extremity Amputation Risk in Diabetic Patients

nurse holding hand of elderly woman patient

Recent studies have elucidated the vascular protective effects of dipeptidyl peptidase-4 (DPP-4) inhibitors. However, to date, no large-scale studies have been carried out to determine the impact of DPP-4 inhibitors on the occurrence of peripheral arterial disease, and lower extremity amputation risk in patients with type 2 diabetes mellitus.

Methods

We conducted a retrospective registry analysis using Taiwan’s National Health Insurance Research Database to investigate the correlation between the use of DPP-4 inhibitors and risk of peripheral arterial disease in patients with type 2 diabetes mellitus. A total of 82,169 propensity score-matched pairs of DPP-4 inhibitor users and nonusers with type 2 diabetes mellitus were examined for the period 2009 to 2011.

Results

The mean age of the study subjects was 58.9 ± 12.0 years, and 54% of subjects were male. During the mean follow-up of 3.0 years (maximum, 4.8 years), a total of 3369 DPP-4 inhibitor users and 3880 DPP-4 inhibitor nonusers were diagnosed with peripheral arterial disease. Compared with nonusers, DPP-4 inhibitor users were associated with a lower risk of peripheral arterial disease (hazard ratio 0.84; 95% confidence interval, 0.80-0.88). Additionally, DPP-4 inhibitor users had a decreased risk of lower-extremity amputation than nonusers (hazard ratio 0.65; 95% confidence interval, 0.54-0.79). The association between use of DPP-4 inhibitors and risk of peripheral arterial disease was also consistent in subgroup analysis.

Conclusions

This large-scale nationwide population-based cohort study is the first to demonstrate that treatment with DPP-4 inhibitors is associated with lower risk of peripheral arterial disease occurrence and limb amputation in patients with type 2 diabetes mellitus.

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-Chun-Chin Chang, MD, Yung-Tai Chen, MD, Chien-Yi Hsu, MD, Yu-Wen Su, MD, Chun-Chih Chiu, MD, Hsin-Bang Leu, MD, PhD, Po-Hsun Huang, MD, PhD, Jaw-Wen Chen, MD, PhD, Shing-Jong Lin, MD, PhD

This article originally appeared in the March 2017 issue of The American Journal of Medicine.

2 Responses to “Dipeptidyl Peptidase-4 Inhibitors, Peripheral Arterial Disease, and Lower Extremity Amputation Risk in Diabetic Patients”

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  2. It was a crisis for me when my father was having a seizure after a stroke in the emergency room but every nurse on staff was needed because a gang of 12 illegal Columbians had come to ER all bloodied up and beaten after a fight. The nurse told me this happens AT LEAST ONCE A WEEK and there’s nothing they can do about it. My father was a WWII vet who paid his taxes and never broke a law or asked anyone for anything and there he was lying there without even a sheet on him, shaking and moaning and no one could attend to him for 30 minutes because a worthless bunch of criminals decided to cause trouble. And guess who pays for their medical care? You and me. Yes, there are very bad illegals that come to this country. There are also good people, I get that. But the laws need to be enforced so that we can get the bad ones out. I don’t think that’s a unreasonable position.

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