Effect Of Sitagliptin Add-on Therapy To Metformin On Antiglycemia,Safty And Additional Benefits In Type2 Diabetics

OBJECTIVE: To study the efficacy,safety,additional benefits of sitagliptin add-on therapy to metformin,and to explore more reasonable combination therapy for glycemic control in type 2 diabetics.METHODS: A total of 115 patients with type 2 diabetes who were treated in Zhongshan hospital affiliated to Dalian University from October 2017 to June 2019 were divided into control groups(36 patients,metformin immediate-release tablets combined with acarbose),study group A(40 patients,metformin immediate-release tablets combined with sitagliptin)and study group B(39 patients,metformin extended-release tablets combined with sitagliptin).Blood glucose(FBG,FPG2 h,H1bAc),lipid profile,HOMA-IR,HOMA-? and GLP-1 levels were measured after 3,6 months treatment respectively.Safety indicators including incidence of hypoglycemia and GI discomforts in the treatment.RESULTS: At 3,6 months treatment,value of H1 bAc in three groups were significantly lower than the baseline(P <0.05),without statistical difference among three groups(P > 0.05).Meanwhile,lipid profile of the three groups were significantly lower than the baseline(P<0.05),with significantly lower level in group studyA and B than in control group(P <0.05).Significant increase in the serum level of GLP-1 were detected in group A and B from baseline(P <0.05),while no significant change in control group.At 6 months treatment,HOMA-IR in three groups were significantly reduced from the baseline(P <0.05),with more significantly decreased in both study group than in control group(P <0.05).HOMA-? in study groups were significantly improved than that at baseline after 6 months treatment(P <0.05).The incidence of GI adverse reactions in study groups A and B was significantly less than that in control group(P <0.05),and there was less GI discomfort in group B than in group A(P<0.05).There was no statistical difference in the incidence of hypoglycemia among three groups(P> 0.05).CONCLUSIONS: 1.Sitagliptin add-on therapy to metformin not only improves blood glucose control but also lipid profile and ?-cell function in type 2 diabetics.2.Sitagliptin add-on therapy to metformin may bring additional benefits of correcting lipid disorders and islet ?-cell dysfunction.3.The combination of metformin sustained-release formulation and sitagliptin is more rational with lower incidence of GI adverse reactions than metformin immediate-release formulation.