TREATMENT WITH GLIPTINS AND STUDY OF THE VARIATIONS IN SERUM AMYLASE AND SERUM LIPASE LEVELS IN TYPE 2 DIABETES MELLITUS

Objective: To observe the variations in levels of serum amylase and serum lipase, in patients with type 2 DM after treatment with DPP-4 inhibitors. METHODS: Under this study, 174 Type 2 diabetes mellitus patients were analysed for variations in levels of exocrine pancreatic enzymes after use of dipeptidyl peptidase (DPP) 4 inhibitors. The effect was compared with those under treatment with other oral hypoglycaemic agents. Cases included in the study (n=90) were patients of type 2 diabetes mellitus on gliptins ± other oral hypoglycemic drugs. The control (n=84) included age and sex matched subjects, treated with other antihyperglycemic agents other than gliptins. Serum amylase and serum lipase levels were monitored at baseline, 3monthly and 6 monthly intervals. Results: Mean serum amylase levels in cases as compared to controls at 3 and 6 monthly intervals were 61.38±14.35U/L;94.57 ± 22.99U/L and 43.34± 9.80U/Land 45.72 ±8.40 U/L respectively. Difference between two groups was statistically significant at both time intervals. Similarly mean serum lipase levels in cases as compared to controls at 3 and 6 monthly intervals were 78.43 ± 44.79U/L;126.59 ± 110.08U/Land 52.17 ± 6.9 U/Land 6.94 ± 15.22U/L respectively. The serum lipase values too demonstrated that the diference between two groups was statistically significant at both time intervals. Conclusion: Significant rise in pancreatic exocrine enzyme levels was observed after treatment with DPP4 inhibitors in Type2 diabetes mellitus patients. None of the patients presented with acute pancreatic inflammation, suggesting that these agents lead to an inflammatory effect in the exocrine pancreas not amounting to clinical expression of pancreatitis