Efficacy of Dapagliflozin + Sitagliptin + Metformin Versus Sitagliptin + Metformin in T2DM Inadequately Controlled on

Related Experiment Video

Updated: Jun 5, 2025

Studying Pancreatic Cancer Stem Cell Characteristics for Developing New Treatment Strategies
07:29

Studying Pancreatic Cancer Stem Cell Characteristics for Developing New Treatment Strategies

Published on: June 20, 2015

19.6K

Awadhesh Kumar Singh1, Ashok Kumar Das2, L Sreenivasa Murthy3

  • 1GD Hospital and Diabetes Institute, 139 A, Lenin Sarani Rd, Bowbazar, Kolkata, West Bengal, 700013, India. drawadheshkumarsingh@gmail.com.

Advances in Therapy
|December 5, 2024
PubMed
Abstract

Insights

A new triple fixed-dose combination (FDC) of dapagliflozin, sitagliptin, and metformin extended release (XR) significantly improved glycemic control in type 2 diabetes patients compared to a dual FDC. The triple FDC demonstrated superior efficacy with a comparable safety profile.

Area of Science:

  • Endocrinology and Metabolism
  • Pharmacology
  • Clinical Trial Research

Background:

  • Limited data hinders fixed-dose combination (FDC) adoption in diabetes management.
  • This study addresses the safety and efficacy of a triple FDC (dapagliflozin + sitagliptin + metformin XR) versus a dual FDC (sitagliptin + metformin XR).
  • The evaluation focuses on type 2 diabetes mellitus (T2DM) patients with inadequate glycemic control on metformin monotherapy.

Purpose of the Study:

  • To assess the efficacy and safety of a triple FDC compared to a dual FDC in T2DM patients.
  • To evaluate glycemic control improvements, including HbA1c, fasting plasma glucose (FPG), and 2-hour post-prandial glucose (PPG).
  • To compare weight changes and the proportion of patients achieving target HbA1c levels.

Main Methods:

  • A randomized controlled trial involving 274 T2DM patients.
  • Patients were randomized to receive either the triple FDC (dapagliflozin 10 mg + sitagliptin 100 mg + metformin XR 1000 mg) or the dual FDC (sitagliptin 100 mg + metformin XR 1000 mg).
  • Treatment duration was 16 weeks, with outcome measures including HbA1c, FPG, PPG, weight, and achievement of HbA1c < 7.0%.

Main Results:

  • The triple FDC group showed a significantly greater reduction in HbA1c (ETD -0.65%, P < 0.0001) compared to the dual FDC group.
  • Significant reductions in FPG (ETD -15.42 mg/dL), PPG (ETD -30.39 mg/dL), and weight (ETD -1.47 kg) were observed with the triple FDC.
  • 54% of patients on the triple FDC achieved HbA1c < 7.0% versus 29.9% on the dual FDC, with comparable adverse event incidence.

Conclusions:

  • The triple FDC (dapagliflozin + sitagliptin + metformin XR) offers superior glycemic control compared to the dual FDC (sitagliptin + metformin XR) in T2DM patients.
  • The enhanced glycemic response was achieved with a comparable safety and tolerability profile.
  • This triple FDC represents an effective treatment option for T2DM patients with poor glycemic control on metformin monotherapy.
Keywords:
DapagliflozinMetforminSitagliptinTriple fixed dose combinationType 2 diabetes

More Related Videos

Author Spotlight: Advancing Diabetes Research with Static Exercise Training in Mice03:17

Author Spotlight: Advancing Diabetes Research with Static Exercise Training in Mice

Published on: March 29, 2024

429
Improving IV Insulin Administration in a Community Hospital12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

18.8K

Related Concept Videos

Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
171
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
172
Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
298
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
139
Oral Hypoglycemic Agents: Sulfonylureas01:17

Oral Hypoglycemic Agents: Sulfonylureas

Sulfonylureas are oral hypoglycemic agents utilized in treating type 2 diabetes. They are characterized by their unique sulfonylurea chemical structure. The family of sulfonylureas is divided into generations. First-generation sulfonylureas, including tolbutamide (Orinase), chlorpropamide (Diabinese), and tolazamide (Tolinase), trigger insulin release from pancreatic β cells and enhance peripheral tissues' insulin sensitivity. The second-generation members, such as glipizide...
187
Oral Hypoglycemic Agents: &#945;-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
159