INTRODUCTION: Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, is an effective and well tolerated incretin-based therapy when used in addition to metformin therapy. There are few studies on its efficacy on glycemic control in triple therapy in combination with other oral antihyperglycemic agents. In this study, we aimed to evaluate the efficacy and safety of sitagliptin add-on metformin and secretogogue combination therapy in type 2 diabetic patients with insufficient glycemic control.
METHODS: The study included 40 patients who were treated with sitagliptin and continued to sitagliptin for 12 months while receiving metformin monotherapy. Age, sex, FBG, HbA1c, urea, creatinine, total cholesterol, triglyceride, LDL, HDL, alanine aminotransferase and aspartate aminotrensferase parameters were evaluated.
RESULTS: The mean age of the 40 patients included in the study was 59,2±9,6 years. The initial HbA1c level was 7,78±0,86%. The rate of HbA1c decline according to the initial level were 0,92%, 1,2% and 0,74% 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 25,1 mg/dl, 24,68 mg/dl and 31,73 mg / dl in the 12th month 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.
DISCUSSION AND 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-secretagogue combinationtreatment (especially HbA1c level 7-8%).