Vildagliptin, a new dipeptidyl peptidase-4 inhibitor, is a useful therapeutic option in patients with type 2 diabetes inadequately controlled with metformin monotherapy Dr. Alan J. Garber in an interview stated that, "Vildagliptin can be used successfully alone or in combination with metformin." "When used in combination, the effects are additive and get many more patients to the glycemic goals required to minimize complications of diabetes."
Dr. Garber, of Baylor College of Medicine, Houston, Texas, and colleagues note that although metformin is the most commonly prescribed first-line antidiabetes drug worldwide, due to the natural progressive worsening of blood glucose control, combination therapy usually becomes necessary.
To investigate whether vildagliptin might be helpful under these circumstances, the researchers studied 544 patients. In addition to continuing their metformin regimen, they were randomized to receive vildagliptin 50 or 100 mg per day or placebo.
At the end of the 24-week study, compared to placebo, there was an adjusted mean 0.7% reduction in HbA1C in the 50 mg group and a 1.1% reduction in the 100 mg group.
There was also a significant improvement in fasting plasma glucose. This amounted to a 0.8 mmol/L reduction in the 50 mg group and 1.7 nmol/L reduction in the 100 mmol/L group. The incidence of adverse events was similar across groups.
"In view of its efficacy and excellent tolerability profile, vildagliptin may be a useful addition to the therapeutic armamentarium for treatment of patients with type 2 diabetes," the researchers conclude.
Diabetes Care 2007;30:890-893.
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Three in Five Diabetics Experience At Least One High-Cost Complication Related to Disease: Three of every five diabetics in the U.S. experience at least one significant complication from the disease, such as heart disease, stroke, eye damage, chronic kidney disease or foot problems leading to amputation. For the study, researchers analyzed data from the National Health and Nutrition Examination Survey conducted by the National Center for Health Statistics between 1999 and 2004. The study found that one in 10 diabetics has two complications, one in 15 has three complications and one in 13 has four or more complications. The study also found that complications are most prevalent among diabetic Hispanics, at a rate of about 68%. About 59% of black diabetics experience diabetes-related complications, and about 55% of white diabetics experience such complications. See this Week’s Item #2 Research presented April 9th, 2007at a meeting of the American Association of Clinical Endocrinologists,