Gemigliptin effective as part of combination drug therapy in type 2 diabetes

This study examined the impact of gemigliptin as part of a combination with metformin (Glucophage) and glimepiride (Amaryl) in patients with type 2 diabetes (T2D). The study found that gemigliptin was effective in the management of T2D in combination with metformin and glimepiride. 

T2D is a progressive disease. At first T2D may be controlled with just one drug. However, if glucose levels remain high more than one drug may be needed.

Metformin is a drug that decreases the amount of glucose that the liver makes in the body. Glimepiride is a type of drug called a sulfonylurea. These drugs lower glucose by stimulating the pancreas to produce more insulin. Gemigliptin is a new type of drug called a dipeptidyl peptidase-4 inhibitor. These drugs lower glucose by increasing insulin production and lowering glucagon production in the body.

Metformin and sulfonylureas are often used together to treat T2D. Gemigliptin has been shown to be effective alone or with metformin. However, gemigliptin has not yet been examined as part of a combination with metformin and a sulfonylurea. 

216 adults with T2D were recruited for this study. All 216 were receiving metformin and glimepiride. All participants had HbA1c (measures average blood glucose over the last 3 months) between 7% and 11%. Half received gemigliptin in addition to their current treatment, while half received a placebo (drug with no active effect). The participants were followed and examined for 24 weeks.

HbA1c decreased by 0.88% in the gemigliptin group, but was reduced only slightly in the placebo group (0.01%). 39.3% of the gemigliptin group reached an HbA1c level below 7%, compared to just 5.5% of the placebo group. Fasting blood glucose (glucose levels after a period without food or drink) was reduced in the gemigliptin group, but increased in the placebo group. Cholesterol was reduced in both groups, but more so in the gemigliptin group.

The number of participants who experienced drug-related side effects was similar in both groups (3.7% in the gemigliptin group and 2.7% in the placebo group). 9.4% of the gemigliptin group experienced hypoglycemia (abnormally low blood glucose) compared to 2.7% of the placebo group. None of the hypoglycemia events were severe. The gemigliptin group experienced an increase in weight, compared to the placebo group.

The study found that gemigliptin was effective in the management of T2D in combination with metformin and glimepiride. The authors recommended that an adjustment of glimepiride should be considered to reduce hypoglycemia. 

This study was funded by LG Life Sciences, the manufacturers of gemigliptin. It examined only a small sample of people for a short period of time.  Only patients receiving relatively high doses of metformin and glimepiride were include. As such, the results may not apply equally to all people with T2D.

Discuss the use of gemigliptin as part of a combination with metformin and a sulfonylurea with your physician.