Effects of Evogliptin as Add on in Type 2 Diabetes (T2DM) Subjects Inadequately Controlled With Metformin and Glimepiride Combination

Objective: To achieve targeted glycemic control people with diabetes required multiple drug therapy. We retrospectively studied effect of adding newly approved DPP4i evogliptin in T2DM subjects having high HbA1c value despite being on tolerable stable doses of Metformin and Glimepiride. Methods: We retrospectively analysed the effects of evogliptin 5 mg OD over 6 month preriod when added to patients who were initially having HbA1c ≥ 7.5% on on stable fixed dose combination of Metformin (1000 -2000 mg/day) and glimiperide (2 - 4 mg/day) at least from 3 months prior. Any patients who were other OHA drugs or in Insulin of have been up or down titrated of the studied drug were excluded. We compared HbA1c, fasting (FPG), postprandrial (PPG) plasma glucose, total cholesterol (TC), triglyceride (TG), HDL, LDL at baseline and after 6months of evogliptin initiation. Self-monitored blood glucose (SMBG) was performed using the patients’ own BG meter. Physicians gave all patients training to ensure they could perform SMBG correctly and accurately. Results: Data of 185 subjects [85(46%) females, Mean age 52.3±2.8 years, mean duration of diabetes 8.2±1.9], who met the inclusion criteria were extracted for analysis from the hospital and clinics records. A drop in HbA1c from 8.8±1.1 to 7.8±0.5% (p<0.05) were resulted after addition of evogliptin. FPG decreased from 159.2±13.5 to 128.3±11.2 and PPG from 238.2±28.7 to 188.1±22.6 respectively (p <0.05). Total cholesterol (TC), triglyceride (TG) were significantly improved after addition of evogliptin, whereas little effect on LDL and HDL. There was no incidence of severe hypoglycemia, though 7 (3.8%) cases of suspected hypoglycemia were managed at home. Conclusion: Evogliptin is a suitable add-on option for those with high HbA1c values as it offer low risk of hypoglycemia despite significant improvement in glycemic parameters.