Efficacy and safety of sitagliptin added to metformin and insulin compared with voglibose in patients with newly diagnosed type 2 diabetes

Abstract

OBJECTIVE: To assess the efficacy and safety of sitagliptin compared with voglibose added to combined metformin and insulin in patients with newly diagnosed type 2 diabetes (T2DM). METHODS: In this 12-week prospective, randomized, parallel trial, 70 newly diagnosed T2DM patients with glycosylated hemoglobin (HbA1c) ≥9% and/or fasting plasma glucose (FPG) ≥11.1 mmol/L were randomized (1:1) to receive sitagliptin 100 mg per day + metformin + insulin glargine or voglibose 0.2 mg three times daily + metformin + insulin glargine. Change in HbA1c at week 12 was the primary endpoint. RESULTS: The mean baseline HbA1c was 11.0% in the patients. The changes in HbA1c from baseline were -6.00% in the sitagliptin group and -3.58% in the voglibose group, and the between-group difference was -2.42% (95% CI -1.91 to -2.93, p =0.02). The differences in FPG and homeostatic model assessment of β-cell function (HOMA-β) and the change in body weight between groups from baseline were -2.95 mmol/L ( p =0.04), 43.91 ( p =0.01) and -2.23 kg ( p =0.01), respectively. One patient (2.9%) in the sitagliptin group and three patients (8.6%) in the voglibose group exhibited hypoglycemia. CONCLUSIONS: Sitagliptin added to combined metformin and insulin therapy showed greater efficacy and good safety regarding hypoglycemia in patients with newly diagnosed T2DM compared with voglibose.

Effect of Sitagliptin and Glimepiride on Pancreatic Beta-Cells during the Treatment of Type-2 Diabetic Mellitus by Statistical Analysis

“…The Fig. 2(a) reflects the blood glucose fasting graph of the drugs effect on clinical data after 26 weeks of sitagliptin (50mg) treatments [11]. This graph also clearly showing the considerable the effect on glycaemic control level.…”

Comparisons between dipeptidyl peptidase-4 inhibitors and other classes of hypoglycemic drugs using two distinct biomarkers of pancreatic beta-cell function: A meta-analysis

“…In this meta-analysis, we retrieved 40 relevant studies from the three databases; MEDLINE, CENTRAL, and Ichushi-web, as shown in the flowchart ( Fig 1 ). Among these studies, data for analysis were available for six of seven DPP-4 inhibitors: alogliptin (n = 2) [ 29 , 30 ], anagliptin (n = 1) [ 31 ], linagliptin (n = 3) [ 32 – 34 ], saxagliptin (n = 4) [ 35 – 38 ], sitagliptin (n = 26) [ 39 – 64 ], and vildagliptin (n = 4) [ 65 – 68 ], but not for teneligliptin (n = 0). Comparators of DPP-4 inhibitors were α-GIs (n = 9) [ 30 , 31 , 34 , 35 , 41 , 50 , 63 – 65 ], GLP-1 analogues (n = 5) [ 47 , 52 , 58 , 62 , 68 ], metformin (n = 5) [ 29 , 38 – 40 , 56 ], SGLT2 inhibitors (n = 5) [ 36 , 53 , 54 , 60 , 61 ], sulfonylureas (n = 12) [ 32 , 33 , 37 , 43 – 46 , 48 , 57 , 59 , 66 , 67 ], and thiazolidinediones (n = 4) [ 42 , 49 , 51 , 55 ].…”

“…These results suggest that DPP-4 inhibitors are superior to α-GIs but inferior to GLP-1 analogues in terms of beta-cell preserving effect. In our meta-analysis between DPP-4 inhibitors and α-GIs using all the retrieved articles, we included a study in which all participants were given insulin [64]. Nevertheless, removal of that study [64] from meta-analysis did not change the statistical results.…”

“…Relevant data for comparing the effect on HOMA-β between DPP-4 inhibitors and other hypoglycemic drugs were available from eight studies of α-GIs [30,31,35,41,50,[63][64][65], five studies of GLP-1 analogues [47, 52, 58, 62,68], five studies of metformin [29,38,39,40,56], five studies of SGLT2 inhibitors [36,53,54,60,61], ten studies of sulfonylureas [37,43,[44][45][46], https://doi.org/10.1371/journal.pone.0236603.g001 (Fig 2). https://doi.org/10.1371/journal.pone.0236603.g002…”

Effect of Add-On Therapy of Sodium-Glucose Cotransporter 2 Inhibitors and Dipeptidyl Peptidase 4 Inhibitors on Adipokines in Type 2 Diabetes Mellitus

“…DPP4 inhibitors enhance glucagon-like peptide-1 and glucose-dependent insulin-tropic polypeptide which leads to increased insulin secretion by β cells of the pancreas and reduced glucagon secretion which in turn lowers glucose production in the liver [19]. Add-on therapy of sitagliptin and vildagliptin is also safe and well-tolerated when combined with metformin [20][21][22].…”