Sitagliptin Add-on to Metformin Therapy: The Efficacy of Dual Therapy on Glycemic Control in Type 2 Diabetes

Year 2019, , 628 - 634, 30.09.2019

Özgür Can , Savaş Volkan Kısıoğlu Sakin Tekin Mehmet Sargın

https://doi.org/10.17098/amj.624529

Abstract

Objectives: Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, is an effective
and well tolerated incretin-based therapy when used in addition to metformin
therapy. We aimed to evaluate the 52-week results of adding sitagliptin to
metformin monotherapy on HbA1c, fasting blood glucose (FBG) and body weight
(BW).

Materials and Methods: The study included 44 patients who were treated with sitagliptin and
continued to sitagliptin for 12 months while receiving metformin monotherapy.
Age, sex, weight, body mass index,FBG, HbA1c, urea, creatinine, total
cholesterol, triglyceride, LDL, HDL, alanine aminotransferase and aspartate
aminotrensferase parameters were evaluated.

Results: The mean age
of the 44 patients included in the study was 58.5 ± 8.9 years. Initially, BWand
BMI were80.36 ± 11.72 kg and 31.14 ± 5.16 kg / m²; respectively. The
initial HbA1c level was 7.5 ± 0.64%. The rates of HbA1cdecline according to the
initial level were 0.82%, 0.86% and 0.9% at 3th, 6th and 12th months;
respectively. There were statistically significant results when the baseline
HbA1c level was compared to 3th, 6th and 12th months’ HbA1c levels. FBG level
decreased 23.65 mg /dl, 26.07 mg / dl and 23.55 mg / dl at 3th, 6th and 12th
months; respectively. There were also statistically significant results when
the baseline FBG level was compared to 3th, 6th and 12th months’ FBG levels. It
was observed that the decline in the FBG continued steadily during 12 months.

Conclusion: Addition of sitagliptin to treatment is an effective and well tolerated
option in patients with type 2 diabetes who are not able to achieve adequate
glycemic control despite metformin monotherapy (especially HbA1c level 7-8%).

Keywords

Fasting Plazma Glucose, HbA1c, Metformin

Tip 2 Diyabet Hastalarının Tedavilerine Sitagliptin Eklenmesinin Glisemik Kontrol Üzerine Etkisi

Abstract

Amaç: Bir
dipeptidil peptidaz-4 (DPP-4) inhibitörü olan sitagliptin, metformin tedavisine
ek olarak kullanıldığında etkili ve iyi tolere edilen inkretin temelli bir
tedavidir. Sitagliptinin metformin monoterapisine eklenmesinin HbA1c, açlık kan
şekeri(AKŞ) ve vücut ağırlığı(VA) üzerine 52 haftalık sonuçlarını
değerlendirmeyi amaçladık.

Materyal ve Metot: Çalışmaya metformin monoterapisi alırken tedavisine sitagliptin eklenen
ve 12 ay boyunca sitagliptin tedavisine devam eden 44 hasta dahil edildi.
Olgularda yaş, cinsiyet, kilo, vücut kitle indeksi (VKİ), AKŞ, HbA1c, üre,
kreatinin, total kolesterol, trigliserit, LDL, HDL, alanin aminotransferaz ve
aspartat aminotrensferaz parametreleri değerlendirmeye alındı.

Bulgular: Çalışmaya
alınan 44 hastanın ortalama yaşı 58,5±8,9 yıl idi. Başlangıçta, VA: 80,36±11,72
kg ve VKİ: 31,14±5,16 kg/m2 idi. Başlangıçtaki HbA1c düzeyi: % 7,5±0,64 olarak
saptandı. HbA1c seviyesinin başlangıç değerlere göre düşüş oranının sırasıyla
3. ayda % 0,82; 6.ayda %0,86 ve 12. ayda % 0, 9 olduğu görüldü. HbA1c düşüşü
başlangıca göre tüm aylarda istatistiksel olarak anlamlı bulundu. AKŞ
seviyesinde başlangıç değerlerine göre sırasıyla 3. ayda 23,65 mg/dl, 6.ayda
26,07 mg/dl ve 12. ayda 23,55 mg/dl düşme olduğu görüldü. AKŞ’de düşüş,
başlangıç değerleri ile karşılaştırıldığında tüm aylarda istatistiksel olarak
anlamlıydı. AKŞ düşüşün 12 ay boyunca istikrarlı bir şekilde devam ettiği
görüldü.

Sonuç: Metformin
monoterapisi kullanımına rağmen yeterli glisemik kontrol sağlanamayan
(özellikle HbA1c düzeyi %7-8) tip 2 diyabetli hastalarda tedaviye sitagliptin
eklenmesi etkin ve iyi tolere edilen bir seçenektir.

Keywords

HbA1c, Metformin, Sitagliptin, açlık kan şekeri

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