Sitagliptin Add-on to Metformin Therapy: The Efficacy of Dual Therapy on Glycemic Control in Type 2 Diabetes
Öz
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%).
Anahtar Kelimeler
Kaynakça
- Diabetes Care 2018;41(Suppl. 1):S1–S2, https://doi.org/10.2337/dc18-SINT01.
- Turner RC, Cull CA, Frighi V, Holman RR. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus—progressive requirement for multiple therapies (UKPDS 49). JAMA 1999;281:2005–12.
- Inzucchi SE. Oral antihyperglycemic therapy for type 2 diabetes scientific review. JAMA 2002;287:360–72.
- Charbonnel B, Karasik A, Liu J, Wu M, Meininger G. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin added to ongoing metformin therapy in patients with type 2 diabetes inadequately controlled with metformin alone. Diabetes Care 2006;29:2638–43.
- Arechavaleta R, Seck T, Chen Y, et al. Efficacy and safety of treatment with sitagliptin or glimepiride in patients with type 2 diabetes inadequately controlled on metformin monotherapy: a randomized, double-blind, non-inferiority trial. Diabetes, Obesity and Metabolism 2011;13:160-8.
- Nauck MA, Meininger G, Sheng D, Terranella L, Stein PP. Sitagliptin Study 024 Group. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor, sitagliptin, compared with the sulfonylurea, glipizide, in patients with type 2 diabetes inadequately controlled on metformin alone: a randomized, double-blind, non-inferiority trial. Diabetes Obes Metab 2007;9(2):194-205.
- Seck T, Nauck M, Sheng D, et al. Sitagliptin Study 024 Group. Safety and efficacy of treatment with sitagliptin or glipizide in patients with type 2 diabetes inadequately controlled on metformin: a 2-year study. Int J Clin Pract 2010;64:562-76.
- Varım C, Uyanık MŞ, Akçay EÜ ve ark. Effects of DPP-4 inhibitors on HbA1c, haematological parameters , parameters of inflammation in the patients with newly diagnosed Type 2 DM. Ortadogu Medical Journal 2015;7(4):172-7.
- Scott R, Loeys T, Davies MJ, Engel SS. Sitagliptin Study 801 Group.Efficacy and safety of sitagliptin when added to ongoing metformin therapy in patients with type 2 diabetes. Diabetes Obes Metab 2008;10:959-69.
Öz
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.
Anahtar Kelimeler
Kaynakça
- Diabetes Care 2018;41(Suppl. 1):S1–S2, https://doi.org/10.2337/dc18-SINT01.
- Turner RC, Cull CA, Frighi V, Holman RR. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus—progressive requirement for multiple therapies (UKPDS 49). JAMA 1999;281:2005–12.
- Inzucchi SE. Oral antihyperglycemic therapy for type 2 diabetes scientific review. JAMA 2002;287:360–72.
- Charbonnel B, Karasik A, Liu J, Wu M, Meininger G. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin added to ongoing metformin therapy in patients with type 2 diabetes inadequately controlled with metformin alone. Diabetes Care 2006;29:2638–43.
- Arechavaleta R, Seck T, Chen Y, et al. Efficacy and safety of treatment with sitagliptin or glimepiride in patients with type 2 diabetes inadequately controlled on metformin monotherapy: a randomized, double-blind, non-inferiority trial. Diabetes, Obesity and Metabolism 2011;13:160-8.
- Nauck MA, Meininger G, Sheng D, Terranella L, Stein PP. Sitagliptin Study 024 Group. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor, sitagliptin, compared with the sulfonylurea, glipizide, in patients with type 2 diabetes inadequately controlled on metformin alone: a randomized, double-blind, non-inferiority trial. Diabetes Obes Metab 2007;9(2):194-205.
- Seck T, Nauck M, Sheng D, et al. Sitagliptin Study 024 Group. Safety and efficacy of treatment with sitagliptin or glipizide in patients with type 2 diabetes inadequately controlled on metformin: a 2-year study. Int J Clin Pract 2010;64:562-76.
- Varım C, Uyanık MŞ, Akçay EÜ ve ark. Effects of DPP-4 inhibitors on HbA1c, haematological parameters , parameters of inflammation in the patients with newly diagnosed Type 2 DM. Ortadogu Medical Journal 2015;7(4):172-7.
- Scott R, Loeys T, Davies MJ, Engel SS. Sitagliptin Study 801 Group.Efficacy and safety of sitagliptin when added to ongoing metformin therapy in patients with type 2 diabetes. Diabetes Obes Metab 2008;10:959-69.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırmalar |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 19 Sayı: 3 |
