Gemigliptin in Diabetic Kidney Disease in Asian Indians with Type 2 Diabetes in Real-Life Scenarios- Insights from Gem Study
Diabetic Kidney disease is strongly associated with cardiovascular events, premature mortality and ESRD. Gemigliptin can be used without dose adjustment in patients with renal failure. The current study aimed to assess the possible renoprotective effects of gemigliptin, using albuminuria and eGFR as indicators. This was a multi-center real-world retrospective analysis of 146 DPP-4 inhibitor naïve type 2 diabetic patients with established moderate DKD (eGFR between 30 to 45 ml/min/1.73 m2 over last 3 months) with diabetic retinopathy who received gemigliptin 50 mg once daily for 24 weeks in addition to anti-hyperglycemic, anti hypertensive’s and statins. Goodness of fit was examined using SPSS statistics 20 and ANOVA was conducted to interpret the results. Baseline characteristics were: 71 (48.6%) males and 75 (51.4%) females, the mean age was 60.81 ± 7.42 years, mean duration was 11.92 ± 3.3 years, mean BMI was 26.54 ± 2.59 kg/m2. Gemigliptin showed significant improvements in glycaemia, renal and lipid parameters with no deterioration in retinopathy, liver enzymes and with no hypoglycemic episodes and was weight neutral. In the present study, gemigliptin reduced albuminuria independent of age, gender, duration of diabetes, Hba1c, eGFR and SBP. It could ameliorate diabetic nephropathy by reducing urine albumin excretion and mitigating the reduction of eGFR in diabetic patients.