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Comparative evaluation of combination of metformin and glimepiride with that of metformin and sitagliptin in type 2 diabetes mellitus with respect to glycemic targets

Mohammad Anjoom, Shaktibala Dutta, Mirza Atif Beg, Amit Varma, Shalu Bawa, Ravi Kant.

Background: Sitagliptin, an oral and selective dipeptidyl peptidase-4 inhibitor, represents a novel therapeutic approach for the treatment of type 2 diabetes mellitus. Metformin and glimepiride are most commonly used oral hypoglycemic agents.

Objective: To compare combination of metformin and glimepiride with that of metformin and sitagliptin in patients with type 2 diabetes mellitus.

Materials and Methods: The study was conducted by Department of Pharmacology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India, in Medicine OPD for 1 year. Total 60 patients with type 2 diabetes mellitus were included in the study. The patients were divided into two groups: Group I (n = 30), patients were put on metformin 500 mg + glimepiride 1 mg once daily and Group II, (n = 30), patients were put on metformin 500 + sitagliptin 50 mg once daily. The patients were stabilized for 2 weeks and followed up every 6 weeks for 24 weeks. Fasting blood sugar (FBS) and postprandial blood sugar (PPBS) were measured at every follow-up; glycosylated hemoglobin (HbA1c) was measured at 0 and 24 weeks. Analysis was done using t-test, and a p-value of 0.05), PPBS (p < 0.05), and HbA1c (p > 0.05) was done. Most common adverse drug reactions were hypoglycemia, abdominal discomfort, weight loss, and nausea/vomiting.

Conclusion: Both groups showed significant improvement in FBS, PPBS, and HbA1c at the end of the study period. Intergroup comparison showed significant improvement in PPG in group II (with a combination of metformin and sitagliptin) at the end of the study.

Key words: Type 2 diabetes mellitus, DPP-4 inhibitors, novel therapeutic approach, HbA1c

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