Sitagliptin and metformin combination therapy for the treatment of Type 2 diabetes

Abstract

Insulin secretion and insulin sensitivity are impaired in Type 2 diabetes. Metformin improves insulin sensitivity by inhibiting hepatic glucose release. It is the preferred drug for first-line treatment in Type 2 diabetes. Sitagliptin, the first marketed dipeptidyl peptidase-IV inhibitor, improves insulin and glucagon secretions of the pancreatic β- and α-cells, respectively, in a strictly glucose-dependent manner by raising endogenous active glucagon-like peptide-1 concentrations. The combination of metformin and sitagliptin thus offers a beneficial and complementary addition of important drug actions on insulin resistance and insulin secretion. Metformin and sitagliptin are also available as a fixed-dose combination. This article reviews the published clinical studies on both substances and their combination, and evaluates the potential benefit of the metformin plus sitagliptin combination.

Keywords::

• dipeptidyl peptidase-IV inhibitors
• DPP-4 inhibitors
• metformin
• oral therapy
• sitagliptin
• Type 2 diabetes

Financial & competing interests disclosure

Baptist Gallwitz is a member on advisory boards for AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Eli Lilly, Novartis, Novo Nordisk, Merck, Roche, Sanofi Aventis and Takeda and has also received honoraria from these companies for giving lectures. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.