Sitagliptin and metformin combination therapy for the treatment of Type 2 diabetes

Figure 1. Glycemic parameters (glycosylated hemoglobin and fasting plasma glucose) over 2 years in patients treated with a combination of sitagliptin as add-on to metformin compared with a combination of glipizide as add-on to metformin. Patients received an add-on therapy of sitagliptin (100 mg once daily, n = 588, dark circles) or glipizide (5-20 mg once daily, n = 584, light circles) to an ongoing metformin treatment over a time period of 2 years. The per-protocol analyses (least-square mean ±standard error) are shown for (A) the HbA_1c and (B) the FPG. FPG: Fasting plasma glucose; HbA_1c : Glycosylated hemoglobin A. Modified from [72].
(Figure omitted. See article PDF.)

Figure 2. Hypoglycemic episodes over 2 years in patients treated with a combination of sitagliptin as an add-on to metformin compared with a combination of glipizide as an add-on to metformin. The proportion of patients with zero, one, two, three, four, five, six or more than six hypoglycemic episodes in the sitagliptin group (dark bars) and glipizide group (light bars) is shown. Hypoglycemias did not have to be verified by a blood glucose measurement. Modified from [72].
(Figure omitted. See article PDF.)

Figure 3. Bodyweight development over 2 years in patients treated with a combination of sitagliptin as an add-on to metformin compared with a combination of glipizide as an add-on to metformin. For the all-patients-as-treated cohort, bodyweight change (least-squares mean change from baseline ±standard error) over 2 years in patients on ongoing metformin therapy treated with sitagliptin 100 mg once daily (dark circles) or glipizide (light circles). Modified from [72].
(Figure omitted. See article PDF.)

There has been a dramatic rise in the incidence and prevalence of Type 2 diabetes in recent years [1,101]. The majority of patients do not reach their treatment goals with the long-standing and established oral medications such as metformin, sulfonylureas, thiazolidinediones and α-glucosidase inhibitors [2,3]. Furthermore, the adverse effects of the sulfonylureas and thiazolidinediones include weight gain [4,5]. Therapy with sulfonylureas is also associated with an increased risk for hypoglycemia; in addition, a loss of efficacy ('secondary failure') occurs with these compounds [3,6,7]. New, effective, safe and tolerable therapies are needed in order to improve medication adherence and to prevent treatment-associated hypoglycemic events and diabetes-associated complications in the...