A class of type 2 diabetes drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors may increase the risk of inflammatory bowel disease, according to a new study published in the peer-reviewed medical journal, The BMJ.
DPP-4 inhibitors include the brand name type 2 diabetes medications Januvia, Onglyza and Tradjenta. DPP4 inhibitors work to reduce blood sugar levels by blocking the action of DPP-4, an enzyme that destroys the hormone incretin. Incretins help the body produce more insulin only when it is needed and reduce the amount of glucose being produced by the liver when it is not needed.
The population-based cohort study, conducted by researchers from the Jewish General Hospital in Montreal, focused on whether the use of DPP-4 inhibitors increased inflammatory bowel disease in type 2 diabetics. The study included more than 141,000 participants who were started on diabetes medications between Jan. 1, 2007, and Dec. 31, 2016. The patients were followed up on through June 30, 2017.
Researchers identified 208 cases of inflammatory bowel disease during 552,413 person-years of follow-up. The data showed that patients treated with DDP-4 inhibitors were more likely to be diagnosed with the bowel disease, and that longer duration increased the risk. The risk of developing the disease decreased after more than four years of use.
“In this first population-based study, the use of DPP-4 inhibitors was associated with an increased risk of inflammatory bowel disease,” the authors wrote. They recommended the study’s findings be replicated with more research. In the meantime, “physicians should be aware of this possible association,” they advised.