ASSOCIATION BETWEEN BILIARY DISEASE, INCLUDING ACUTE CHOLECYSTITIS,AND DIPEPTIDYL PEPTIDASE 4 INHIBITORS USE IN PATIENTS WITH TYPE 2 DIABETES MELITTUS

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a global health challenge associated with multiple significant complications. Recent studies suggest that use of dipeptidyl peptidase 4 (DPP-4) inhibitors, may be linked to acute cholecystitis and biliary dysfunction. Understanding this association is important, as biliary complications may adversely affect patient outcomes.

Objective: To explore the association between biliary disease, including acute cholecystitis, in patients with type 2 diabetes mellitus treated with DPP-4 inhibitors.

Material and Methods: This cross-sectional study was conducted between Nov 2022 to August 2024 at PAF Hospital, Islamabad. The study population had two qual groups of 350 patients each comprising type 2 diabetic patients receiving DPP-4 inhibitors and those receiving other ant diabetic medications. The data regarding demographic characteristics and biliary outcomes were collected from their medical records using a structured questionnaire and analyzed using SPSS version 25 to find the association between biliary disease and use of DPP4 inhibitors.

Results: Patients receiving DPP-4 inhibitors showed a significantly higher frequency of acute cholecystitis compared to those receiving other antidiabetic medications (16.0% vs 10.0%, p=0.027; OR=1.71, 95% CI: 1.09–2.68). There were also higher frequencies of gallstones (22.0% vs 16.0%, p=0.153; OR=1.48, 95% CI: 0.99–2.20)and biliary sludge (24.0% vs 18.3%, p=0.076; OR=1.41, 95% CI: 0.97–2.05)in the DPP-4 inhibitor group; however, these differences were not statistically significant.

Conclusion: Our findings suggests an association between use of DPP-4 inhibitors and a higher frequency of acute cholecystitis and biliary disease in patients with type 2 diabetes mellitus, warranting careful monitoring in clinical practice.