Study On The Effect Of Sitagliptin In Diabetes Patients With Chronic Hepatitis B

Objective:To evaluate the efficacy and safety of sitagliptin treatment for type 2 diabetes mellitus complicated with chronic hepatitis B.Methods:We retrospectively collected 528 patients with type 2 diabetes mellitus complicated with chronic hepatitis B from January 2012 to May 2017.They were divided into two groups:the sitagliptin group and the control group according to whether sitagliptin was used or not.The propensity score-matching was adopted.The patient's general data(age;gender;body mass index;diabetes history;coexisting diseases and medications),insulin dose,Child-Pugh grading,glycated hemoglobin(HbA1c)values,alanine aminotransferase(ALT)levels,aspartate aminotransferase(AST)levels,total bilirubin(TBil)values,hypoglycemia,and other adverse events were recorded.Results:A total of 215 patients were enrolled in the study,there were 43 patients in each group after the propensity score-matching.Compared with the status before treatment,the blood ALT,AST,and TBil values decreased significantly at week 12 after treatment,and the HbAlc value and insulin dose at week 12 in the sitagliptin group decreased significantly(p<0.05),but there were no obvious significant differences in the control group(p>0.05).There was no significant change in BMI before and after treatment in the two groups(both p>0.05).Compared with those in the control group,HbAlc values and insulin doses decreased significantly at week 12 in the sitagliptin group(p<0.05),but there was no difference in target glucose levels including hypoglycemia rate,?BMI,Ablood ALT levels,?AST levels,and ?TBil levels between the two groups(??value at week 12 after treatment-baseline value before treatment).There were also no statistically significant differences in adverse events,such as nausea,dizziness,and rash,between the two groups.Conclusion:In patients with type 2 diabetes and chronic hepatitis B,insulin and sitagliptin could effectively control blood glucose and reduce insulin dosage without further impairing liver function with the administration of antiviral and hepatoprotective drugs that stabilize liver function.