Add-On Sitagliptin Linked to Lower Risk for Insulin Initiation in Type 2 Diabetes

(HealthDay News) — For patients with type 2 diabetes treated with metformin, add-on sitagliptin is associated with a lower risk for insulin initiation than add-on sulphonylurea, according to a study published in Diabetes, Obesity and Metabolism.

Silvio E. Inzucchi, MD, from the Yale University School of Medicine in New Haven, Connecticut, and colleagues conducted a retrospective cohort study to examine time to insulin initiation among patients with type 2 diabetes treated with sitagliptin vs. sulphonylurea as an add-on to metformin

Participants were aged 18 years and older with continuous medical records and an initial prescription of sitagliptin or sulphonylurea with metformin for 90 days or more during 2006 to 2013. A total of 3,864 propensity-score-matched pairs were analyzed.

The risk for insulin initiation was lower for sitagliptin users vs. sulphonylurea users over 6 years (26.6% vs. 34.1%), the researchers found. After adjustment for baseline characteristics, the findings persisted (hazard ratio, 0.76; 95% CI, 0.65-0.9). 

Compared with sulphonylurea users, sitagliptin users were less likely to initiate insulin in conditional logistic regression analyses.

“In this real-world matched cohort study, patients with [type 2 diabetes] treated with sitagliptin had a significantly lower risk of insulin initiation compared with patients treated with sulphonylurea, both as add-on to metformin,” the researchers wrote.

Several authors disclosed financial ties to pharmaceutical companies, including Merck, the manufacturer of sitagliptin.


  1. Inzucchi SE, Tunceli K, Qiu Y, et al. Progression to insulin therapy among patients with type 2 diabetes treated with sitagliptin or sulphonylurea plus metformin dual therapy. Diabetes Obes Metab. 2015;17(10):956-964.