EFFICACY AND SAFETY OF METFORMIN PLUS SITAGLIPTIN COMBINATION THERAPY VERSUS METFORMIN ALONE IN TREATMENT PATIENTS WITH TYPE 2 DIABETES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Type 2 diabetes is one of the most common chronic diseases that is associated with insulin resistance and increased blood sugar levels, and affects the morbidity, mortality, and quality of life of the patients. This study was conducted with the aim of investigating the safety and effectiveness of sitagliptin and metformin combined treatment compared to metformin treatment alone in patients with type 2 diabetes.

A systematic search was conducted in PubMed, Cochrane Library, Embase, Scopus, and Web of Science databases until November 2020. The Cochrane tool was used to assess the quality of the studies. Meta-analysis was performed using RevMan software version 5.3.

Nine studies were included with a total number of 5675 patients. The results showed that in except of the comparision of the dose of 1000 mg with 100/1000 mg, there was significant differences between the two treatment groups in respect of HbA1c level. FPG was significant only at a dose of 1000 mg versus 50/1000 mg (P = 0.0001). Significant differences in the outcome of HOMA-B were observed in the studied doses. However, no significant difference was observed between the two treatment groups in the outcomes of HOMA-IR and Fasting proinsulin. Proinsulin/insulin ratio was significant only at a dose of 1000 mg versus 50/1000 mg (P <0000.1). The outcome of one or more side effects was higher at doses of 500 mg versus 50.500 (P = 0.20) and 1000 mg versus 1000/100 in the combination group (P= 0.02).

Sitagliptin and metformin combination therapy showed better efficacy than metformin treatment alone in patients with type 2 diabetes. No significant adverse events were observed for combination therapy.