Comparing the efficacy and safety profile of sitagliptin versus glimepiride in
patients of type 2 diabetes mellitus inadequately controlled with metformin
alone.
Author(s): Srivastava S, Saxena GN, Keshwani P, Gupta R.
Affiliation(s): Department of Medicine, S.M.S Medical College, Jaipur.
Publication date & source: 2012, J Assoc Physicians India. , 60:27-30
OBJECTIVE: To compare the efficacy and safety of sitagliptin and glimepiride in
treatment of patients with type 2 diabetes mellitus inadequately controlled with
metformin alone.
RESEARCH DESIGN AND METHODS: In an 18 week, randomized parallel group
interventional trial, 50 subjects who were only on metformin as antidiabetic
agent, with inadequate glycemic control, were randomized to either sitagliptin
50/100mg or glimepiride 1/2 mg per day. Dose of drugs was adjusted after 4 weeks
if glycemic control was not reached.
RESULTS: At 18 weeks both groups (sitagliptin and glimepiride) produced
significant (P < 0.001) reduction in HbA1C (-0.636% and -1.172% respectively),
with 12% patients in sitagliptin group and 36% patients in glimepiride group
achieving target HbA1C. Reduction was also significant (P < 0.001) in both groups
in FPG (-15.49 mg and -29.84 mg respectively) and 2HPPG (-34.28 mg and -44.83 mg
respectively). Sitagliptin group showed net decrease in bodyweight by 0.102 kg
whereas glimepiride group showed net increase in body weight by 0.493 kg.
Incidence of hypoglycemia was 4% in sitagliptin group and 8% in glimepiride
group.
CONCLUSION: In this study addition of sitagliptin and glimepiride to metformin
monotherapy, produced significant improvement in glycemic control. Benefits were
more with glimepiride in comparison to sitagliptin. Sitagliptin was well
tolerated, with lower risk of hypoglycemia than glimepiride, and produced weight
loss as compared to weight gain with glimepiride.
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