A recent study published in Frontiers Endocrinology highlighted the role of vildagliptin on glycemic variability in patients with type 2 diabetes mellitus (T2DM). The study aimed to determine the effect of vildagliptin on patients on mixed insulin therapy. 

Patients with T2DM with poor glycemic control and who were on premixed insulin therapy were included in the study. Patients having insulin doses without adding vildagliptin, matched for HbA1c, age, BMI, and diabetes duration, were included in the control group. All patients had undergone glycated hemoglobin(HbA1c), FGM, and glycated albumin(GA) measurements at baseline and at 3 months after treatment.

Significant reductions in HbA1c and GA levels were seen in patients receiving vildagliptin treatment. With decrease in mean amplitude of glycemic excursion (MAGE) (8.58 ± 0.36 vs. 6.62 ± 0.47, P<0.001) while reduction in mean blood glucose (MBG) (10.7 ± 0.34 vs. 8.82 ± 0.39, P<0.001) and time above the target range (TAR) (52.60 ± 3.44 vs. 31.59 ± 4.31, P<0.001) was found in vildagliptin group compared to control group. Improvement in duration spent within the target range (TIR) (45.64 ± 3.33 vs. 64.22 ± 4.00, P<0.001) was also seen. While an increase in areas under the curve (AUC) for blood glucose levels above 4.4 (426.82 ± 83.19 vs. 892.16 ± 185.27, P=0.018) and 3.9 (213.81 ± 47.20 vs. 454.77 ± 103.21, P=0.029) was also observed. FGM indicated lower blood glucose levels in the vildagliptin group, specifically after dinner when hourly mean blood glucose was monitored over 2 weeks.