Add-On Sitagliptin Linked to Lower Risk for Insulin Initiation in Type 2 Diabetes
Adding sitagliptin to metformin may reduce risk for insulin initiation.
(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.