The Glycemic Outcomes of Metformin with Add-on Vildagliptin or Sitagliptin in T2DM

Introduction: T2DM is a global health concern requiring effective glycaemic management to reduce complications. While DPP-4 inhibitors like vildagliptin and sitagliptin are widely used in combination with metformin, limited studies have compared their efficacy in lowering plasma glucose levels. This study aims to address this gap by evaluating the effectiveness of these combinations in glycaemic control. This study aims to address this gap by evaluating the effectiveness of these combinations in glycemic control. Objective: To compare the glycemic outcomes of vildagliptin with metformin versus sitagliptin with metformin in patients with T2DM, focusing on HbA1c reduction as the primary indicator. Methods: A comparative observational study on 172 T2DM patients (≥ 30 years) was done with comorbidities like hypertension, dyslipidemia, and obesity. Inclusion required lab data (FBG, PLBS, HbA1c, Cr, TG) and consent, while exclusions included T1DM, gestational diabetes, insulin therapy, alcohol use, and emergencies. Outcomes assessed were primary (HbA1c), secondary (Cr, TG). Hypothesis: Null (H0): There is no difference in the efficacy of Vildagliptin + Metformin versus Sitagliptin + Metformin. Alternative (Ha): There is a significant difference in the efficacy of Vildagliptin + Metformin versus Sitagliptin + Metformin. Results and conclusion: The study showed that adding vildagliptin or sitagliptin to metformin significantly improved glycaemic control in T2DM over six months. Both combinations effectively reduced FBS, PLBS, HbA1c, and TG without affecting renal function. Vildagliptin achieved slightly better glycaemic reductions compared to sitagliptin with add-on metformin. Both treatments were well-tolerated, with no significant side effects including renal dysfunction or hyperlipidemia. These findings confirm the safety and efficacy of both therapies, with vildagliptin having a slight edge.