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Posted by on Jun 7, 2015 in Diabetes mellitus | 0 comments

In a nutshell

This study examined whether sitagliptin delays the need for insulin therapy in type 2 diabetics in comparison to a sulfonylurea.

Some background

Patients with type 2 diabetes (T2D) initially produce insulin (hormone which lowers blood sugar levels) but it fails to work in the body. Drugs such as metformin (Glucophage) aim to help insulin work in the body. However, over time insulin production decreases. Metformin is therefore generally combined with sitagliptin (Januvia) or a sulfonylurea drug such as glipizide (Glucotrol). Both sitagliptin and sulfonylureas increase the release of insulin from the pancreas. However, the effectiveness of these drugs decreases over time as the pancreas stops producing insulin. Patients then require insulin therapy.

Insulin therapy can cause low blood glucose levels and weight gain. Therefore, it is preferable to delay the time at which insulin is needed. It is believed that sitagliptin can delay the time at which patients begin insulin therapy.

Methods & findings

This study aimed to determine the time at which T2D patients begin insulin therapy following treatment with sitagliptin or a sulfonylurea.

This study involved 7728 T2D patients. Half of the patients received metformin with sitagliptin, while the other half received metformin with a sulfonylurea. The time at which patients were given their first prescription for sitagliptin or a sulfonylurea was recorded. The time at which patients first began insulin therapy was also noted.

Fewer patients (26.6%) using sitagliptin required insulin therapy after 6 years in comparison to patients using a sulfonylurea (34.1%). Patients using sitagliptin had a 24% lower risk of initiating insulin therapy after 6 years than those using a sulfonylurea.

The bottom line

This study concluded that patients treated with sitagliptin had a lower risk of initiating insulin therapy in comparison to a sulfonylurea.

The fine print

This study did not assess whether treatment with sitagliptin after treatment with a sulfonylurea can also lower the risk.

What’s next?

Consult your physician regarding the risks and benefits of sitagliptin treatment. 

Published By :

Diabetes, Obesity and Metabolism

Date :

May 11, 2015

Original Title :

Progression to insulin therapy among type 2 diabetes patients treated with sitagliptin or sulfonylurea plus metformin dual therapy.

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