Publication:

Comparison of combination metformin-vildagliptin versus metformin-glimepiride in patients of type 2 diabetes mellitus with inadequately controlled metformin monotherapy

Background Metformin has been recommended as a first-line therapy for T2DM in many guidelines. Adding a sulfonylurea to metformin has been a conventional and gold standard for decades to achieve tight glycaemic control. dipeptidyl peptidase-4 (DPP-4) inhibitors, an incretin-based therapy has emerged as important adjunctive drugs in T2DM. Therefore, the present study was planned to evaluate and compare the efficacy and safety of combination metformin-vildagliptin and metformin-glimepiride in patients of T2DM inadequately controlled with metformin monotherapy.

Methods A total 45 patients were allocated to each metformin-vildagliptin group and metformin-glimepiride group. Fasting plasma glucose, post prandial plasma glucose, body weight, adverse events were recorded at 0 week, 6 weeks, and 12 weeks. Glycosylated haemoglobin was recorded at 0 week and 12 weeks.

Results There was no statistically significant difference between the two groups (p>0.05) at the end of 12 weeks in the mean percentage reduction in FPG, PPPG and HbA1c.There was statistically highly significant (p 0.05).

Conclusions In patients of T2DM with inadequately controlled metformin monotherapy, combination metformin-vildagliptin provides comparable efficacy in terms of FPG, PPPG and HbA1c to that of combination metformin-glimepiride with no risk of weight gain reduction in risk of hypoglycemic events.