Effectiveness of adding vildagliptin to the treatment of diabetic patients nonresponsive to the combination of metformin and a sulphonylurea

Abstract

OBJECTIVE: To evaluate the effectiveness of adding vildagliptin to the treatment of patients with inadequately controlled type 2 diabetes mellitus (T2DM) treated with a combination of metformin and a sulphonylurea. SUBJECTS AND METHODS: 37 T2DM patients with HbA1c ranging from 7.7% to 12.4% (mean of 9.30 ± 1.38), despite the use of metformin in combination with a sulphonylurea, were additionally treated with vildagliptin (100 mg/day) for at least 6 months. RESULTS: During triple oral therapy (TOT) HbA1c levels < 7% were achieved in 11 patients (29.7%), whereas levels of fasting plasma glucose (FPG) < 120 mg/dL were observed in 12 patients (32.4%). Both findings were observed in 10 patients (27.0%). Compared to nonresponsive subjects, lower mean baseline HbA1c and FPG levels were seen in responsive patients, but the difference was only statistically significant for fasting plasma glucose (FPG). Moreover, there was considerable overlap between the two groups. CONLUSION: Our preliminary results suggest that TOT with metformin, a sulphonylurea and vildagliptin may be useful for some T2DM patients nonresponsive to combination therapy with metformin and sulphonylurea.

A randomized controlled trial of the efficacy and safety of saxagliptin as add‐on therapy in patients with type 2 diabetes and inadequate glycaemic control on metformin plus a sulphonylurea

“…These findings are consistent with previous studies of DPP‐4 inhibitors as add‐on therapy in patients not adequately controlled on a combination of metformin and a sulphonylurea. Triple oral therapy with vildagliptin or sitagliptin in combination with metformin and a sulphonylurea has been demonstrated to significantly improve glycaemic control with a small or non‐significant change in body mass index or body weight. Collectively, the results of these studies demonstrate DPP‐4 inhibitors to be effective in improving glycaemic control as add‐on therapy to metformin plus a sulphonylurea without increasing the risk of severe hypoglycaemia.…”