EXPERIENCE OF USING A DPP-4 INHIBITOR IN CLINICAL PRACTICE
Keywords:
diabetes mellitus, prevalence, therapy, sitagliptin, metforminAbstract
Objective: According to modern recommendations for the management of patients with type 2 diabetes, it is possible to use different combinations of hypoglycemic agents.
Aim: to evaluate the effect of combination therapy with sitagliptin and metformin on carbohydrate and fat metabolism in patients with type 2 diabetes.
Materials and methods: Methods of examination included the collection of anamnesis, the measurement of anthropometric indicators. All patients underwent determination of plasma glucose both on an empty stomach and postprandially, glycated hemoglobin, lipid profile, levels of insulin, proinsulin, C-peptide in the blood.
Results: The study examined the effect of sitagliptin in combination with metformin and metformin monotherapy on carbohydrate and fat metabolism in patients requiring intensification of therapy. According to the data obtained, after 24 weeks, the positive dynamics of HbA1c was accompanied by a significant decrease in the average values of fasting glycemia and postprandial glycemia in group I, while in group II (on metformin monotherapy), the decrease in glycemia did not reach statistical significance. The study showed a significant improvement in the functional activity of pancreatic β-cells during the combination therapy with sitagliptin and metformin, which was confirmed by an increase in the HOMA-β index, a decrease in the proinsulin/insulin ratio, in contrast to metformin monotherapy, where the change in these indicators did not reach statistical significance.
Conclusion: As a result of intensification of therapy by adding sitagliptin to metformin, in patients with type 2 diabetes and obesity, compared with metformin monotherapy, more pronounced, important non-glycemic effects were obtained in the form of a decrease in BMI. In patients with type 2 diabetes and obesity, the functional activity of pancreatic β-cells improved, the glycemic profile and the level of glycated hemoglobin improved.
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