In a nutshell
The present study compared the effctiveness of two types of drugs that can be added to Metformin (Glucophage) for the treatment of poorly controlled type 2 diabetes mellitus (T2DM).
Some background
Type 2 diabetes mellitus affects almost 10% of all adults. Metformin (Glucophage) is the most common drug used to treat T2DM. When patients on Metformin are unable to control their blood glucose levels (have poor glycemic control), they need additional drugs. Usually, Sulfonylureas are offered to such patients, for example Glimepiride (Amaryl). However, this class can cause weight gain, hypoglycemia (very low glucose levels), reduce the quality of life, and increase the risk of heart attack and stroke. Another optional second medicine is one of the DPP-4 inhibitors class of anti-diabetic drugs, such as Linagliptin (Tradjenta, Trajenta). These oral drugs slow digestion, and indirectly increase insulin release.
Methods & findings
This large study was conducted in 209 medical centers throughout 16 countries for 2 years. 1551 patients were divided into 2 groups, receiving either Linagliptin or Glimepiride in addition to Metformin.
The results show that Linagliptin and Glimepiride were equally successful in lowering blood glucose levels. However, Linagliptin significantly reduced the risk of hypoglycemia compared to Glimepiride. Patients treated with Glimepiride had almost 5 times more hypoglycemic events. Patients who took Linagliptin gained significantly less weight and were also less likely to suffer from cardiovascular events, such as heart attack and stroke.
The bottom line
In conclusion, both drugs showed equal efficiency in glycemic control, but Linagliptin had a safer side effect profile compared to Glimepiride.
The fine print
This trial was funded by Boehringer Ingelheim, the pharmaceutical company that manufactures Linagliptin.
Published By :
The Lancet
Date :
Aug 04, 2012
