Safety and Efficacy of Sitagliptin Compared With Glimepiride in Patients With Type 2 Diabetes Mellitus Inadequately Controlled With Metformin Monotherapy

Background: type 2 diabetes mellitus (dm) is a chronic disease requiring lifelong treatment. therefore, assessment of the long-term safety and tolerability of newer therapeutic agents is of importance. the objective of this study was to compare safety and efficacy of sitagliptin with glimepiride in patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy. material & methods: patients with type 2 dm inadequately controlled with metformin monotherapy were randomized to receive sitagliptin 100mg or glimepiride 2mg once daily as add-on therapy for 12 weeks. primary end point was the number of patients achieving hba1c <7%, while secondary end points were change in hba1c, fasting blood sugar (fbs) and weight from baseline and the safety profile of the two drugs. results: a total of 40 patients with type 2 dm inadequately controlled with metformin monotherapy were randomized to recieve sitagliptin or glimepiride as add-on therapy. there were 21 patients in sitagliptin group and 19 patients in glimepiride group. primary end point was reached in 57% patients in sitagliptin group and 52.6% patients in glimepiride group, p=0.68. hba1c was reduced more in sitagliptin group (-1.04±0.2%) as compared to glimepiride group (-0.96±0.3). both groups caused the reduction in fbs. sitagliptin caused reduction in weight while in glimepiride group there was increase in weight (-2.7±2.2kg vs. +2.5±0.6kg, p=0.002). both the drugs were well tolerated with no serious side effects. conclusion: sitagliptin is as efficacious as glimepiride in reducing hba1c and fasting blood sugar. it also causes reduction in weight and is well tolerated