PMID- 26500706 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20151027 LR - 20220410 IS - 1758-5996 (Print) IS - 1758-5996 (Electronic) IS - 1758-5996 (Linking) VI - 7 DP - 2015 TI - Efficacy and safety of vildagliptin, sitagliptin, and linagliptin as add-on therapy in Chinese patients with T2DM inadequately controlled with dual combination of insulin and traditional oral hypoglycemic agent. PG - 91 LID - 10.1186/s13098-015-0087-3 [doi] LID - 91 AB - OBJECTIVE: We aimed to evaluate the efficacy and safety of the three dipeptidyl peptidase 4 (DPP-4) inhibitors (vildagliptin, sitagliptin, and linagliptin) as add-on therapy in Chinese patients with type 2 diabetes mellitus (T2DM)inadequately controlled on dual combination of insulin and metformin or acarbose. METHODS: A total of 535 T2DM patients who failed to achieve glycemic control with insulin and a traditional oral hypoglycemic agent were randomized to receive vildagliptin, sitagliptin, or linagliptin. Body mass index, glycosylated hemoglobin (HbA1c), fasting and postprandial plasma glucose (FPG and PPG), insulin dose, and adverse events were evaluated during the study. RESULTS: The baseline HbA1c was 9.59 +/- 1.84 % (vildagliptin group), 9.22 +/- 1.60 % (sitagliptin group), and 9.58 +/- 1.80 % (linagliptin group). At week 12 it was 8.16 +/- 1.29 % (vildagliptin), 8.56 +/- 1.96 % (linagliptin), and 8.26 +/- 1.10 % (sitagliptin). The changes in HbA1c from baseline were -1.33 +/- 0.11 % (vildagliptin), -0.84 +/- 0.08 % (sitagliptin) and -0.81 +/- 0.08 % (linagliptin), the vildagliptin group had the greatest reduction in HbA1c (P < 0.05). The proportions of patients that reached target HbA1c were 66.27 % (vildagliptin), 52.73 % (sitagliptin), and 55.49 % (linagliptin), the vildagliptin group had the highest one (P < 0.05). The baseline FPG and PPG values in the three groups were at the same level. At week 12, mean FPG levels in the vildagliptin (7.31 +/- 1.50 mmol/L) and linagliptin (6.90 +/- 1.55 mmol/L) groups were significantly lower than in the sitagliptin group (8.02 +/- 4.48 mmol/L; P < 0.05); the linagliptin group had the lowest mean PPG followed by the vildagliptin group which was also significant lower (P = 0.000) than the sitagliptin group. Additionally, the required insulin dosage in the vildagliptin group was the lowest among the groups at weeks 6 and 12. Only mild AEs were reported during the study. CONCLUSION: The three DPP-4 inhibitors appear to be effective and safe as add-on therapy for T2DM patients on dual combination of insulin and a traditional OHA. Vildagliptin was more effective in decreasing insulin requirement and achieving glycemic control when compared to the other two. FAU - Tang, Yun-Zhao AU - Tang YZ AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Wang, Gang AU - Wang G AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Jiang, Zhen-Huan AU - Jiang ZH AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Yan, Tian-Tian AU - Yan TT AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Chen, Yi-Jun AU - Chen YJ AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Yang, Min AU - Yang M AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Meng, Ling-Ling AU - Meng LL AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Zhu, Yan-Juan AU - Zhu YJ AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Li, Chen-Guang AU - Li CG AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Li, Zhu AU - Li Z AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Yu, Ping AU - Yu P AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. FAU - Ni, Chang-Lin AU - Ni CL AD - Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China. LA - eng PT - Journal Article DEP - 20151019 PL - England TA - Diabetol Metab Syndr JT - Diabetology & metabolic syndrome JID - 101488958 PMC - PMC4616160 OTO - NOTNLM OT - Add-on therapy to insulin OT - DPP-4 inhibitors OT - Glycemic control OT - Type 2 diabetes mellitus EDAT- 2015/10/27 06:00 MHDA- 2015/10/27 06:01 PMCR- 2015/10/19 CRDT- 2015/10/27 06:00 PHST- 2015/06/17 00:00 [received] PHST- 2015/10/08 00:00 [accepted] PHST- 2015/10/27 06:00 [entrez] PHST- 2015/10/27 06:00 [pubmed] PHST- 2015/10/27 06:01 [medline] PHST- 2015/10/19 00:00 [pmc-release] AID - 87 [pii] AID - 10.1186/s13098-015-0087-3 [doi] PST - epublish SO - Diabetol Metab Syndr. 2015 Oct 19;7:91. doi: 10.1186/s13098-015-0087-3. eCollection 2015.