Oleh Admin Kalbe Medical pada December 04, 2017 07:30

Manfaat Pemberian Obat Diabetes Metformin Bersama dengan Obat DPP-4 Inhibitor terhadap Jantung

Suatu penelitian yang dilakukan oleh Dr. Matthew J. Crowley yang telah dipublikasikan secara online pada jurnal kedokteran, Diabetes Care, mendapatkan hasil bahwa mengonsumsi obat diabetes metformin bersama-sama dengan obat diabetes golongan DPP-4 inhibitor dikaitkan dengan adanya efek baik terhadap fungsi kardiovaskular (jantung dan pembuluh darah). Analisis tersebut didapatkan dari suatu hasil studi meta-analisis dari 3 buah penelitian.

Saat ini, cukup banyak beredar obat diabetes golongan DPP-4 inhibitor di Indonesia, antara lain saxagliptin, sitagliptin, vildagliptin, dan linagliptin. Berdasarkan beberapa penelitian yang dilakukan untuk melihat adanya kejadian penyakit jantung dari obat-obat DPP-4 inhibitor, masih belum dapat diketahui apakah pemberian DPP-4 inhibitor tersebut bersifat netral, ada manfaat, atau memberikan dampak buruk. Efek pada jantung dari obat diabetes DPP-4 inhibitor yang berbeda-beda tersebut bisa jadi juga dipengaruhi oleh apakah obat tersebut sedang diresepkan bersama dengan metformin atau tidak. Hal tersebut disampaikan oleh Dr. Matthew J. Crowley dari Durham VA Medical Center and Duke University School of Medicine, di Durham, Carolina Utara.

   
Dr. Crowley dan timnya menyelidiki lebih dalam mengenai cara mengobati diabetes dengan metformin sebagai suatu moderator potensial terhadap munculnya dampak kardiovaskular dari DPP-4 inhibitor. Tercetus ide untuk melakukan analisis ini karena telah diketahui salah satu mekanisme kerja obat metformin adalah meningkatkan produksi hormon inkretin dari saluran cerna, sedangkan obat DPP-4 inhibitor menghambat degradasi hormon inkretin. Secara keseluruhan, pengobatan diabetes dengan golongan DPP-4 inhibitor memiliki efek yang netral terhadap munculnya penyakit kardiovaskular berupa gabungan dari kematian kardiovaskular, miokard infark nonfatal, atau stroke nonfatal.


Hasilnya penelitian ini adalah dengan diberikan obat diabetes metformin di saat yang bersamaan dengan DPP-4 inhibitor, terjadi tren penurunan kejadian dari munculnya penyakit jantung seperti yang disebutkan di atas, sedangkan hal sebaliknya terjadi jika tidak mengonsumsi metformin. Analisis tersebut bersifat eksplorasi, obat diabetes DPP-4 inhibitor bisa jadi tepat digunakan bersama dengan obat metformin. Seperti yang diketahui bahwa obat diabetes metformin telah menjadi terapi lini pertama dalam pengobatan diabetes tipe 2 (DM tipe 2), sehingga dengan adanya hasil ini maka akan semakin menegaskan posisi obat diabetes metformin serta manfaatnya dalam sistem kardiovaskular (jantung dan pembuluh darah). (PMD)


Image : Ilustrasi
Referensi:
1.Boggs W. Cardiovascular effects of DPP-4 inhibitors tied to metformin use [Internet]. 2017 [cited 2017 November 29]. Available from: https://www.medscape.com/viewarticle/889125.
2.Crowley MJ, Williams JW Jr, Kosinski AS, D'Alessio DA, Buse JB. Metformin use may moderate the effect of DPP-4 inhibitors on cardiovascular outcome. Diabetes Care 2017;40(12):1787-9. doi: 10.2337/dc17-1528.

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