Comparison of Sitagliptin Monotherapy with Combination Therapy

The aim of this study was to compare the effects of sitagliptin in monotherapy and combination (metformin or pioglitazone) treatments on glycemic control, lipid profile and insulin resistance. A total of 46 type 2 diabetic patients, who were newly diagnosed and who had not previously received antidiabetic therapy, were included in the study. Patients were randomly assigned to receive sitagliptin (group 1), sitagliptin + metformin (group 2) or sitagliptin + pioglitazone (group 3). Sitagliptin 100 mg/day, metformin 2000 mg/day and pioglitazone 30 mg/day were used in the treatment. All patients completed the six-month follow-up period. Patients were evaluated at baseline and at the end of the study in terms of anthropometric measurements, glycemic parameters and lipid levels. Initial anthropometric measurements, glycemic parameters and lipid profiles were similar. At the end of the sixth month, a statistically significant decrease in body mass index (BMI) was observed in group 1, while there was no statistically significant difference in group 2 and 3. Hemoglobin A1c was significantly decreased in all three groups and no statistically significant difference was found between the groups. Serum triglyceride levels were significantly decreased in group 3 at the end of the sixth month and no difference was found between the three groups in terms of their effects on the other lipid profile. When HOMA-IR was evaluated, there was no significant difference in group 1 and group 2 at the end of 6 months, whereas there was a significant decrease in group 3 (p <0.05). The effects of sitagliptin monotherapy, sitagliptin+metformin and sitagliptin+pioglitazone combination treatments on glycemic values and lipid profile were similar. Sitagliptin+pioglitazone combination therapy was found to be superior in reducing insulin resistance and triglyceride levels