Drug combo works synergistically in type 2 diabetes
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In people with type 2 diabetes, the combination of two anti-diabetes drugs—sitagliptin and metformin—improves blood sugar control in a synergistic fashion, a study shows.
In type 2 diabetes, a person becomes less sensitive to the effects of insulin, a hormone that helps the body use sugar for fuel. The drug metformin works by making the body more responsive to insulin, while the drug sitagliptin works to boost the body’s ability to lower elevated blood sugar levels.
Because sitagliptin and metformin lower blood sugar “through different, but potentially complementary, mechanisms” the combination “should provide effective, potentially additive,” blood sugar control, Dr. Debora E. Williams-Herman of Merck Research Laboratories, Rahway, New Jersey and colleagues write in the journal Diabetes Care.
To investigate, they randomized 1,091 type 2 diabetics to sitagliptin plus metformin, metformin alone, sitagliptin alone or inactive placebo. At the start of the study, the average A1C level—a common measure of blood sugar control—was 8.8 percent, which is considered high.
All patients on active treatment had “meaningful” reductions in blood sugar levels compared with those on placebo. At 24 weeks, 66 percent of patients treated with sitagliptin and metformin had an A1C of less than 7 percent, and 44 percent of this group reached a value of less than 6.5 percent.
This was significantly better than results with a single drug, the team notes, and “demonstrated an additive response.”
There was a low incidence of hypoglycemia, or low blood sugar, which was not significantly different from that in the placebo group.
This study shows that the combination of sitagliptin and metformin provides “substantial and additive” improvement in blood sugar levels and is “generally well tolerated,” the team concludes.
SOURCE: Diabetes Care, August 2007.
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