Comparison of Efficacy of Dipeptidyl Peptidase-4-Inhibitor Versus Sulfonylureas in Type 2 Diabetes Patients Inadequately Controlled with Metformin; A Narrative Review
| Autor: | Majed S. Al Yami, Meshary Alkahtani, Ahmed Elmubark |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
endocrine system diseases medicine.drug_class business.industry Public Health Environmental and Occupational Health nutritional and metabolic diseases Type 2 diabetes Dipeptidyl peptidase-4 inhibitor medicine.disease Sulfonylurea Gastroenterology Metformin Glimepiride Internal medicine Diabetes mellitus Sitagliptin medicine business medicine.drug Glycemic |
| Zdroj: | Indian Journal of Public Health Research & Development. |
| ISSN: | 0976-5506 0976-0245 |
| Popis: | Objectives: The aim of this review is to evaluate efficacy of Dipeptidyl peptidase-IV-inhibitor (DPP-4 inhibitors) compared to sulfonylureas (SU) in type two diabetes patients who were not adequately controlled with metformin. Method: Relevant articles were identified from PubMed, Scopus, Cochrane, Embase and some journals websites, all studies published between 2007 until 2018 were included. Key words used were: Dipeptidyl peptidase-IV-inhibitor, sulfonylurea, efficacy and cardiovascular. Both RCTs and Non- RCTs studies were included Results: Most of the studies that evaluated glycosylated hemoglobin (HbA1c) and fasting plasma glucose reduction between SU and DPP-4 inhibitors revealed almost similar reduction rate. Accumulating evidences showed no statistically significant difference between the two groups. Few studies claimed that SU had better HbA1c reduction rate, however, with minimal significance. In addition, evidence showed no significant effect on HDL or LDL. Sitagliptin associated with -5.3% decreased in triglyceride level compared to 2.1% increased with glimepiride, resulting in a between-group difference of ?6.1% (?10.4, ?1.7), favoring sitagliptin. DPP-4 inhibitors added to metformin may be associated with fewer macrovascular complications compare to SU combination with metformin. Conclusion: It seems that DPP-4 inhibitors and SU has comparable glycemic control and overall efficacy with no significant effect on HDL or LDL and slight effect on TG. DPP-4 inhibitors combination showed fewer macrovascular complications. |
| Databáze: | OpenAIRE |
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