Sitagliptin: Is It Effective in Routine Clinical Practice?

Area of Science:

• Endocrinology
• Pharmacology
• Clinical Medicine

Background:

• Type 2 diabetes mellitus (T2DM) is a global health concern requiring effective glycemic control.
• Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, is widely used for T2DM management.
• Understanding sitagliptin's real-world effectiveness beyond clinical trials is crucial.

Purpose of the Study:

• To evaluate the glycemic effects of sitagliptin in a Malaysian population with type 2 diabetes.
• To assess changes in glycated hemoglobin (HbA1c) levels over 12 months of sitagliptin treatment in routine clinical practice.

Main Methods:

• Retrospective analysis of medical records from 457 type 2 diabetes patients treated between 2009 and 2012.
• Measurement and analysis of HbA1c levels at baseline and up to 12 months post-sitagliptin initiation.
• Statistical analysis using a generalized linear model with Generalized Estimating Equations (GEE) to account for changes in HbA1c.

Main Results:

• Mean HbA1c decreased from 8.5% at baseline to 7.7% at 3-6 months (mean difference: 0.8%, P < 0.001).
• The HbA1c reduction was less pronounced between 7-12 months, with levels rising to 8.0% (mean difference from baseline: 0.6%, P < 0.001).
• The majority of patients were overweight (81.4%) and elderly (53.6%).

Conclusions:

• Sitagliptin demonstrates significant HbA1c reduction in the initial 6 months of use in routine clinical practice.
• The observed glycemic control with sitagliptin aligns with findings from controlled clinical trials.
• Sustained glycemic efficacy of sitagliptin may be reduced in the later period (7-12 months) of treatment.