30 Oct Diabetes: Study Compares Gliptins vs Sulfonylureas as Add-Ons to Metformin
MedicalResearch.com Interview with:
Dr. Yung-Tai Chen MD
Division of Nephrology
Department of Medicine
Taipei City Hospital
Heping Fuyou Branch
Medical Research: What is the background for this study? What are the main findings?
Dr. Chen: Recent studies concluded that dipeptidyl peptidase-4 (DPP-4) inhibitors can provide glycemic control but also raised concerns about the risk of heart failure in patients with Type 2 Diabetes Mellitus (T2DM). However, large-scale studies of the effects of DPP-4 inhibitors versus sulfonylureas (SUs) on cardiovascular outcomes when used as add-ons to metformin therapy remain scarce. Our study showed that compared to SUs, DPP-4 inhibitors were associated with a lower risk of all-cause mortality, stroke and hypoglycemia as an add-on to metformin. Besides, dipeptidyl peptidase-4 inhibitors had comparable risks of hospitalization for heart failure to sulfonylureas as add-ons to metformin.
Medical Research: What should clinicians and patients take away from your report?
Dr. Chen: The results of present study found dipeptidyl peptidase-4 inhibitors reduced the risks of all-cause mortality and stroke, but did not alter the risks of myocardial infarction and hospitalization for heart failure relative to sulfonylureas as add-ons to metformin. However patients with type 2 diabetes mellitus belong to a heterogeneous subpopulation, treatment regimens of oral hypoglycemic agents should still be individualized based on the effects of blood glucose control and cardiovascular safety.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Chen: Our study was a retrospective observational study. Further RCT study was warranted to validate our findings.
Effects on Clinical Outcomes of Adding Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylureas to Metformin Therapy in Patients With Type 2 Diabetes Mellitus
Shuo-Ming Ou, MD*; Chia-Jen Shih, MD*; Pei-Wen Chao, MD; Hsi Chu, MD; Shu-Chen Kuo, MD, PhD; Yi-Jung Lee, MD; Shuu-Jiun Wang, MD; Chih-Yu Yang, MD, PhD; Chih-Ching Lin, MD, PhD; Tzeng-Ji Chen, MD, PhD; Der-Cherng Tarng, MD, PhD; Szu-Yuan Li, MD, PhD; and Yung-Tai Chen, MD
Ann Intern Med. Published online 13 October 2015 doi:10.7326/M15-0308
Dr. Yung-Tai Chen MD (2015). Diabetes: Study Compares Gliptins vs Sulfonylureas as Add-Ons to Metformin