2026-05-05T18:39:53Zhttps://uvadoc.uva.es/oai/request

oai:uvadoc.uva.es:10324/693102024-07-30T19:01:42Zcom_10324_40357com_10324_952com_10324_894col_10324_40358

00925njm 22002777a 4500 dc Gabriel, Rafael author Boukichou Abdelkader, Nisa author Gilis-Januszewska, Aleksandra author Makrilakis, Konstantinos author Gómez Huelgas, Ricardo author Kamenov, Zdravko author Paulweber, Bernhard author Satman, Ilhan author Djordjevic, Predrag author Alkandari, Abdullah author Mitrakou, Asimina author Lalic, Nebojsa author Egido, Jesús author Más Fontao, Sebastián author Calvet, Jean Henri author Pastor Jimeno, José Carlos author Lindström, Jaana author Lind, Marcus author Acosta, Tania author Silva, Luis author Tuomilehto, Jaakko author 2023 Objective: To compare the effect of glucose-lowering drugs on peripheral nerve and kidney function in prediabetes. Methods: Multicenter, randomized, placebo-controlled trial in 658 adults with prediabetes treated for 1 year with metformin, linagliptin, their combination or placebo. Endpoints are small fiber peripheral neuropathy (SFPN) risk estimated by foot electrochemical skin conductance (FESC < 70 μSiemens) and estimated glomerular filtration rate (eGFR). Results: Compared to the placebo, the proportion of SFPN was reduced by 25.1% (95% CI:16.3–33.9) with metformin alone, by 17.3% (95% CI 7.4–27.2) with linagliptin alone, and by 19.5% (95% CI 10.1–29.0) with the combination linagliptin/metformin (p < 0.0001 for all comparisons). eGFR remained +3.3 mL/min (95% CI: 0.38–6.22) higher with the combination linagliptin/metformin than with the placebo (p = 0.03). Fasting plasma glucose (FPG) decreased more with metformin monotherapy −0.3 mmol/L (95%CI: −0.48; 0.12, p = 0.0009) and with the combination metformin/linagliptin −0.2 mmol/L (95% CI: −0.37; −0.03) than with the placebo (p = 0.0219). Body weight (BW) decreased by −2.0 kg (95% CI: −5.65; −1.65, p = 0.0006) with metformin monotherapy, and by −1.9 kg (95% CI: −3.02; −0.97) with the combination metformin/linagliptin as compared to the placebo (p = 0.0002). Conclusions: in people with prediabetes, a 1 year treatment with metformin and linagliptin, combined or in monotherapy, was associated with a lower risk of SFPN, and with a lower decrease in eGFR, than treatment with placebo. Journal of Clinical Medicine, 2023, Vol. 12, Nº. 5, 2035 2077-0383 https://uvadoc.uva.es/handle/10324/69310 10.3390/jcm12052035 2035 5 Journal of Clinical Medicine 12 2077-0383 Diabetes - Diagnosis Diabetes - Prevention Diabetes - Prevención Diabetes - Treatment Diabetes - Tratamiento Nervous system - Diseases Nervioso, Sistema - Enfermedades Sistema nervioso periférico - Enfermedades Neuropatia Neurology Kidneys - Diseases Riñones - Enfermedades Pharmacology Drugs Medicamentos Lifestyle Calidad de vida Clinical trials Ensayos clínicos Public health Reduction in the risk of peripheral neuropathy and lower decrease in kidney function with metformin, linagliptin or their fixed-dose combination compared to placebo in prediabetes: a randomized controlled trial