Start of therapy of type 2 diabetes mellitus with a fixed combination. Metformin with vildagliptin or glibenclamide, is there any difference?

Background. The widespread prevalence of type 2 diabetes mellitus (DM2), the associated high mortality and disability of patients are the reason for the constant active search for effective approaches to hypoglycemic therapy. The right choice of drugs for the initial DM2 treatment is especially relevant, which can lay the foundation for achieving long-term goals of glycemic control, thereby preventing the development of serious complications. In our work, we studied one of the approaches to the initial DM2 treatment, namely the use of a fixed combination of vildagliptin+meformin at a dose of50/1000 mg twice a day compared with the more conventional treatment option: a fixed combination of glibenclamide and metformin at a dose of2.5/500 mg twice a day. Objective. Evaluation of the dynamics of glycemic control indicators, body mass index (BMI) and the time-to-3rd hypoglicemic drug for patients with T2DM who received one of the listed options for a fixed combination at the start of therapy. Methods. Study sample was formed from the database of the Moscow segment of the Federal Diabetes Register, which was used as a data source. Results. Moreover, by the end of the observation, a statistically significant lower glycated hemoglobin (НЬАіс) level and BMI was observed in patients receiving vildagliptin+metformincompared to patients receiving glibenclamide+metformin (p<0.05). After 8 years of follow-up, 62.5% of patients from the vildagliptin+metformin group and 44.3% of patients from the glibenclamide+metformin group had an HbAlc level of <7.0% (p<0.05). Conclusion. The observation confirmed the possibility of maintaining long-term stable glycemic control without gaining body weight in DM2 patients who received a combination of vildagliptin+metformin.

Federal Diabetes Register, metformin, glibenclamide, vildagliptin, dipeptidylpeptidase- 4 inhibitors, dipeptylpeptidase