Comparison of the efficacy and safety of Metformin versus Sitagliptin among treatment naïve patients of Type-2 Diabetes.

Abstract

Objective: To compare the efficacy and safety of metformin versus Sitagliptin among treatment naïve patients of type-2 diabetes mellitus (T2DM). Study Design: Randomized Controlled Trial. Setting: Department of Medicine, Unit-III, Bahawal Victoria Hospital, Bahawalpur. Period: September 2021 to August 2022. Material & Methods: During the study period, a total of 320 treatment naïve T2DM patients (160 in each group) were randomly enrolled and followed up. Baseline demographics of all patients including gender, age, BMI (kg/m2), fasting plasma glucose (FPG) and baseline HbA1c were recorded. Patients of Group-A were given oral Sitagliptin 100mg once daily whereas patient in Group-B were prescribed oral metformin as 500-2000 mg per day aiming achievement of glycemic goals. Repeat HbA1c and FPG levels were tested at the end of 12^th and 24^th weeks therapy among both study groups. Side effects related to studied drugs were also observed and recorded. Results: Out of a total of 320 patients, 57 patients (27 in Group-A and 30 in Group-B) lost follow up so 263 patients were included in the final analysis. Majority of the patients, 134 (51.0%) were male. Mean age, BMI and duration of diabetes among study participants were 53.07+9.62 years, 29.44+4.74 kg/m² and 1.96+2.3 years respectively. No statistically significant difference was noted at zero, 12 or 24 weeks in between both study groups (p>0.05) in terms of reduction in HbA1c or FPG levels during the study period (p>0.05). Conclusion: Both metformin and Sitagliptin effectively reduce HbA1c and FPG levels among treatment naïve T2DM patients with relatively good tolerability and safety. Both study drugs can be used as initial monotherapy among T2DM patients with relatively mild-to-moderate disease.