Triple oral therapy with metformin, <scp>DPP</scp> ‐4 inhibitor, and <scp>SGLT2</scp> inhibitor for adults with type 2 diabetes: Consensus recommendations of a Chinese expert panel (version 2025)

Type 2 diabetes mellitus (T2DM) is a progressive disease involving multiple pathophysiologic defects, and combination therapy is often required to achieve and sustain glycaemic control. Triple oral therapy with metformin, dipeptidyl peptidase-4 inhibitors (DPP-4i), and sodium-glucose cotransporter-2 inhibitors (SGLT2i) has demonstrated high and durable glycaemic-lowering efficacy, favourable safety and tolerability, and additional metabolic benefits in T2DM patients with diverse background therapies, including those who are treatment-naïve and those with inadequate control on monotherapy or dual therapy. In light of the increasing clinical use of this triple regimen and the absence of established consensus to guide its use, the Diabetes Committee of the Chinese Research Hospital Association convened an expert panel comprising endocrinologists and evidence-based experts. Through a systematic literature review and a Delphi process, the panel formulated 11 consensus recommendations (8 strong and 3 weak recommendations) on the clinical use of metformin + DPP-4i + SGLT2i, including fixed-dose combination formulations. Safety considerations regarding its use were also described. This consensus aimed to provide clinicians with practical guidance to optimize the effective and safe use of metformin + DPP-4i + SGLT2i in T2DM management.

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Publication Details

Journal
Diabetes Obesity and Metabolism
Published
2025-10-14
DOI
https://doi.org/10.1111/dom.70197
Citations
2
Primary Topic
Diabetes Treatment and Management
Type
article
Field-Weighted Citation Impact
2.59
Controls
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article

Triple oral therapy with metformin, DPP ‐4 inhibitor, and SGLT2 inhibitor for adults with type 2 diabetes: Consensus recommendations of a Chinese expert panel (version 2025)

Yaoming Xue, Lixin Guo, Yan Bi, Deying Kang et al.
2 citations
Diabetes Obesity and Metabolism
Diabetes Treatment and Management
2.59
article

Triple oral therapy with metformin, DPP ‐4 inhibitor, and SGLT2 inhibitor for adults with type 2 diabetes: Consensus recommendations of a Chinese expert panel (version 2025)

Yaoming Xue, Lixin Guo, Yan Bi, Deying Kang, Guangda Xiang, Tong Wang, Guang Wang, Ling Gao, Miao Yu, Tao Yang, Zhiguang Zhou, Chun Xu
article en
2 citations

Abstract

Type 2 diabetes mellitus (T2DM) is a progressive disease involving multiple pathophysiologic defects, and combination therapy is often required to achieve and sustain glycaemic control. Triple oral therapy with metformin, dipeptidyl peptidase-4 inhibitors (DPP-4i), and sodium-glucose cotransporter-2 inhibitors (SGLT2i) has demonstrated high and durable glycaemic-lowering efficacy, favourable safety and tolerability, and additional metabolic benefits in T2DM patients with diverse background therapies, including those who are treatment-naïve and those with inadequate control on monotherapy or dual therapy. In light of the increasing clinical use of this triple regimen and the absence of established consensus to guide its use, the Diabetes Committee of the Chinese Research Hospital Association convened an expert panel comprising endocrinologists and evidence-based experts. Through a systematic literature review and a Delphi process, the panel formulated 11 consensus recommendations (8 strong and 3 weak recommendations) on the clinical use of metformin + DPP-4i + SGLT2i, including fixed-dose combination formulations. Safety considerations regarding its use were also described. This consensus aimed to provide clinicians with practical guidance to optimize the effective and safe use of metformin + DPP-4i + SGLT2i in T2DM management.

Diabetes Obesity and MetabolismVol. 27(S9)
Central South University (CN), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Sichuan University (CN), Beijing Chao-Yang Hospital, Capital Medical University (CN), Peking Union Medical College Hospital (CN), Chinese PLA General Hospital (CN), Wuhan University (CN), West China Hospital of Sichuan University (CN), 307th Hospital of Chinese People’s Liberation Army (CN), Nanjing Drum Tower Hospital (CN), Second Affiliated Hospital of Nanjing Medical University (CN), Renmin Hospital of Wuhan University (CN), Central Hospital of Wuhan (CN), The 309th Hospital of Chinese People's Liberation Army (CN), Wuhan General Hospital of Guangzhou (CN), Second Xiangya Hospital of Central South University (CN), Southern Medical University (CN), Nanjing Medical University (CN)
Openalex Percentile: Top 8%
Diabetes Treatment and Management
2.59
DOIOpen Access PDFOpenAlex
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