Sitagliptin vs. pioglitazone as add-on treatments in patients with uncontrolled type 2 diabetes on the maximal dose of metformin plus sulfonylurea

Khaloo, Pegah; Alemi, Hamid; Mansournia, Mohammad Alì; Mohammadi, Aeen; Yadegar, Amirhossein; Afarideh, Mohsen; Esteghamati, Sadaf; Nakhjavani, M; Esteghamati, Alireza

doi:10.1007/s40618-018-0991-0

Cited by 3 publications

(4 citation statements)

References 36 publications

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“…In the current investigation, the effects of adding sitagliptin and pioglitazone to the metforminsulfonylurea treatment of patients with inadequate glycemic control showed that both drugs could improve the HbA1c level; nevertheless, this improvement was not statistically significant. Similarly, Khaloo et al (7) reported that sitagliptin and pioglitazone had similar effects on the level of HbA1c. Jameshorani et al (20) also reported the similar effects of sitagliptin and pioglitazone in combination with metformin on the improvement of HbA1c.…”

Section: Discussionmentioning

confidence: 84%

“…These drugs, including pioglitazone, improve insulin resistance through the activation of peroxisome proliferator-activated receptor-γ in the liver and adipose tissues (3,4). Pioglitazone can also improve the lipid profile, liver function, blood pressure, and body weight (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

“…However, the results of a study carried out on the effects of sulfonylureas, thiazolidinediones, and DPP-4 inhibitors in combination with metformin showed that thiazolidinediones exert long-term effects (16). In addition, the findings of another study indicated that some patients undergoing combined metforminsulfonylurea therapy may not achieve the desired glycemic control and a third drug may be needed (7).…”

Section: Introductionmentioning

confidence: 99%

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Effective Reduction of Inflammatory and Coagulation Factors using Sitagliptin in Type 2 Diabetes

Ghavami

Houshyar

Mehdizadeh

et al. 2021

ircmj

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Introduction: There are different drug-based treatments (i.e., oral or injective) for patients with type 2 diabetes. Pioglitazone and sitagliptin, among oral agents, can affect blood glucose control and lipid profile. Objectives: The purpose of the current investigation was the assessment of the effects of adding sitagliptin or pioglitazone (as the third drug) to the combined metformin-sulfonylurea treatment on glycemic control, inflammatory factors, and lipid profile. Methods: This clinical trial was carried out on 125 patients with type 2 diabetes undergoing metformin-glibenclamide treatment. The patients were randomly divided into three groups, namely the sitagliptin group receiving 100 mg of sitagliptin for 3 months (n=45), pioglitazone group receiving 30 mg of pioglitazone for 3 months (n=40), and control group (n=40). After the interventions, the anthropometric indices, glycated hemoglobin A1c level, lipid profile, fibrinogen, and high-sensitivity C-reactive protein (hs-CRP) were compared among the study groups. Results: The sitagliptin group demonstrated significantly lower levels of hs-CRP (0.53±0.26 mg/L) and fibrinogen (314.08±48.09 mg/dL), compared to those reported for the pioglitazone and control groups. In contrast, significantly lower triglyceride levels (115.02±32.92 mg/dL) and significantly higher high-density lipoprotein cholesterol (51.57±11.14 mg/dL) were observed in the pioglitazone group in comparison to those reported for the sitagliptin and control groups. Conclusion: The results of the present study suggest that sitagliptin reduces the levels of fibrinogen and hs-CRP. Nevertheless, pioglitazone has a more significant effect on the improvement of the lipid profile, compared to sitagliptin and combined metformin-sulfonylurea treatments.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effective Reduction of Inflammatory and Coagulation Factors using Sitagliptin in Type 2 Diabetes

Ghavami

Houshyar

Mehdizadeh

et al. 2021

ircmj

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“…We further excluded 54 of them for various reasons such as insufficient data, inappropriate control or not random clinical trials. Finally, 14 RCTs, [15][16][17][18][19][20][21][22][23][24][25][26][27][28] fulfilled all inclusion criteria included in the analysis. The flowchart of the study selection process is shown in Fig.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Effects of sitagliptin on serum lipid levels in patients with type 2 diabetes: a systematic review and meta-analysis

Zhou

Sun

et al. 2021

Journal of Cardiovascular Medicine

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Aim Lipid abnormalities often occur in patients with diabetes mellitus and the coexistence of diabetes mellitus and dyslipidaemia will increase the risk of cardiovascular diseases. However, the specific effects of sitagliptin on lipid control remain elusive in diabetic patients. The aim of this meta-analysis is to investigate the effects of sitagliptin alone or with other antidiabetic agents on serum lipid control. Methods PubMed, Cochrane Library, Embase and the ClinicalTrials.gov website were systematically searched from 2006 (the first year that sitagliptin entered market) to 16 January 2021. Eligible studies were randomized clinical trials (RCTs) of sitagliptin including outcomes of serum total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C) or low-density lipoprotein cholesterol (LDL-C). Results A total of 14 RCTs with 2654 patients were identified. Treatment with sitagliptin alone or in combination with other antidiabetic agents significantly reduced serum TC [mean difference (MD) = —5.52 95% confidence interval (95% CI), —7.88 to —3.15; P < 0.00001] and LDL-C (MD = —0.07; 95% CI, —0.14 to 0.00; P < 0.00001) in patients with type 2 diabetes. No statistical significances were found in serum triglycerides (MD = 1.53; 95% CI, —8.22 to 11.28; P = 0.76) or HDL-C (MD = 0.65; 95% CI, —1.59 to 0.29; P = 0.18). Subgroup analyses suggest that sitagliptin can significantly decrease serum LDL-C, TC and triglyceride levels compared with placebo alone, and no statistical significance was found in comparison with the serum HDLC levels. Conclusion Sitagliptin alone or in combination with other antidiabetic agents significantly reduces serum TC and LDL-C in patients with type 2 diabetes mellitus, while no significant difference was observed in serum triglycerides or HDL-C.

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Effects of pioglitazone on cardiovascular events and all-cause mortality in patients with type 2 diabetes: A meta-analysis of randomized controlled trials

Mannucci

Giaccari

Gallo

et al. 2022

Nutrition, Metabolism and Cardiovascular Diseases

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Sitagliptin vs. pioglitazone as add-on treatments in patients with uncontrolled type 2 diabetes on the maximal dose of metformin plus sulfonylurea

Cited by 3 publications

References 36 publications

Effective Reduction of Inflammatory and Coagulation Factors using Sitagliptin in Type 2 Diabetes

Effective Reduction of Inflammatory and Coagulation Factors using Sitagliptin in Type 2 Diabetes

Effects of sitagliptin on serum lipid levels in patients with type 2 diabetes: a systematic review and meta-analysis

Effects of pioglitazone on cardiovascular events and all-cause mortality in patients with type 2 diabetes: A meta-analysis of randomized controlled trials

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