Anti-Inflammatory Effects of Metformin and Saxagliptin in Patients with Type 2 Diabetes Mellitus

Introduction: Type 2 diabetes mellitus (T2DM) is a chronic condition characterized by hyperglycemia, insulin resistance, and low-grade inflammation, contributing to complications like cardiovascular disease. Elevated inflammatory biomarkers, such as CRP and IL-6, worsen disease progression and outcomes. Metformin, a first-line therapy for T2DM, and saxagliptin, a DPP-4 inhibitor, are known for their glycaemic benefits and potential anti-inflammatory effects. This study investigates the impact of metformin monotherapy and metformin-saxagliptin combination therapy on inflammatory biomarkers in T2DM to inform more comprehensive treatment strategies. Materials and Methods: A prospective observational study enrolled 100 newly diagnosed T2DM patients (aged 18–60) from Osmania Medical College, Hyderabad. Participants were divided into two groups: Group A (metformin monotherapy, n=50) and Group B (metformin-saxagliptin, n=50). Serum CRP and IL-6 levels were measured at baseline, 6 months, and 12 months. Statistical analyses included paired t-tests, independent t-tests, and ANOVA, with a significance level of p < 0.05. Results: CRP levels declined significantly in both groups (Group A: 4.66 ± 0.39 to 2.77 ± 0.23; Group B: 4.68 ± 0.37 to 2.78 ± 0.22; p=0.795). IL-6 levels also decreased in both groups, with a greater reduction observed in Group B (32.19 ± 1.26 vs. 28.42 ± 0.65; p<0.0001). These findings indicate that both treatments effectively reduce inflammation, but the combination therapy showed superior IL-6 modulation. Conclusion: Both metformin monotherapy and combination therapy with saxagliptin reduce inflammation in T2DM. Sitagliptin’s enhanced effect on IL-6 underscores its potential for optimizing inflammatory and metabolic management.