Itoprid helps diabetics with reduced gastrointestinal motility improve diabetes control

Methodology and Study Objectives

The aim of the study conducted by Indian authors, published in the summer of 2019, was to describe the clinical profile of patients with diabetes and reduced GI motility and assess the significance of itoprid in alleviating gastroparesis symptoms and maintaining blood glucose levels within the proper range. A total of 41 patients with diabetes aged 18–65 years and with scintigraphically proven GI motility disorders in the last 6 months, who were prescribed itoprid by their treating physician, were included.

In addition to the clinical profile of patients, changes in the severity of gastroparesis symptoms, glycemic parameters, treatment tolerance, and quality of life using the PAGI-QoL tool (Patient Assessment of upper GI disorders – Quality of Life) were monitored over 8 weeks of treatment with this prokinetic. PAGI-QoL includes 30 items rated on a severity scale of 0–5 for each item. The maximum score, indicating the worst possible quality of life related to upper GI tract disorders, is 150.

Findings

The average age of the study participants was 51.8 years, with 46.3% being men. Patients had an average BMI of 26.5 kg/m², an average diabetes duration of 81 months, and an average duration of GI motility disorder of 68 months. The most common symptoms reported by patients before the study began were bloating (in 68.3% of cases), postprandial fullness (61%), nausea (51.2%), early satiety (41.5%), heartburn (39%), and vomiting (9.8%).

Eight weeks of itoprid treatment led to a significant reduction in the severity or complete disappearance of all symptoms of reduced GI motility (p < 0.001). After 8 weeks of itoprid treatment, no patient rated any of their symptoms as severe. This was accompanied by an improvement in the quality of life score according to PAGI-QoL from 63.8 to 50 (p < 0.0001).

Furthermore, significant improvement in glycemic parameters was observed after 8 weeks of itoprid treatment. Compared to baseline, glycated hemoglobin (HbA_1c) decreased from 62 to 53 mmol/mol (p < 0.001), fasting glucose from 8.0 to 7.1 mmol/l (p = 0.004), and postprandial glucose from 11.7 to 10.4 mmol/l (p = 0.004).

Itoprid was very well tolerated. No adverse events related to its administration were reported during the study.

Conclusion

This study conducted on an Indian population indirectly suggests a connection between reduced gastric emptying speed and poorer diabetes control. As shown in the study, the prokinetic itoprid can not only alleviate the unpleasant symptoms of GI motility disorder in diabetics but also improve HbA_1c values, fasting glucose, and postprandial glucose levels.

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Source: Rai R. R., Choubal C. C., Agarwal M. et al. A prospective multicentric postmarketing observational study to characterize the patient population with reduced gastrointestinal motility among Indian diabetic patients receiving itopride: the Progress study. Int J Appl Basic Med Res 2019; 9 (3): 148–153, doi: 10.4103/ijabmr.IJABMR_351_18.