ADVANTAGES OF EARLY COMBINED THERAPY WITH VILDAGLIPTIN AND METFORMIN IN PATIENTS WITH TYPE 2 DEABETES MELLITUS

Authors

  • Didushko O. M. Ivano-Frankivsk National Medical University, Chair of Endocrinology, Ivano-Frankivsk, Ukraine

DOI:

https://doi.org/10.21856/j-PEP.2020.3.17

Keywords:

type 2 diabetes mellitus, combined therapy, vildagliptin, metformin, review

Abstract

In recent years, there is a tendency towards an increasing number of people living with diabetes mellitus. Among all patients with diabetes, more than 90 % have type 2 diabetes mellitus (T2DM). It is important that besides increased T2DM morbidity, the frequency of diabetic complications is increasing too. Clinical inertia is considered as one of the causes of increased macrovascular complications risk, and the positive «metabolic memory» in patients newly diagnosed with T2DM as an early predictor of diabetic complications. The concept of «metabolic memory» allows for the necessity of maximally effective controlling glycemia already at first signs of impaired carbohydrate metabolism (e. g. administering a drug combination). According to meta-analysis data of study with a relatively short observation period, combined therapy with metformin and DPP-4 inhibitors in the early stages is most effective and safe. Peculiar attention is paid in the article to a recently presented study, VERIFY. This is a five-year-long study of long-term results of the early combined therapy with vildagliptin and metformin. The study was conducted in 254 research sites of 34 countries with 2001 patients of different ethnic backgrounds with recently diagnosed T2DM who had not gotten therapy earlier (glycated hemoglobin (HbA1c) level was 6.5–7.5 %) or had gotten metformin for not longer than a month. The patients were divided into two groups: one group got monotherapy with metformin, the second one got metformin and vildagliptin combination straight away. The main parameter of the study was the time before unsuccessful starting therapy and the necessity to start insulin therapy. The results of the VERIFY study demonstrate unambiguously that the early combined therapy with vildagliptin and metformin ensures more significant and lasting long-term advantages for the patients. Nowadays recommended method of starting monotherapy with further intensification during the treatment of patients with T2DM is a less effective treatment strategy.

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Published

2021-08-17

How to Cite

Didushko , O. M. . (2021). ADVANTAGES OF EARLY COMBINED THERAPY WITH VILDAGLIPTIN AND METFORMIN IN PATIENTS WITH TYPE 2 DEABETES MELLITUS . Problems of Endocrine Pathology, 73(3), 136-142. https://doi.org/10.21856/j-PEP.2020.3.17

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Section

TO PRACTICING ENDOCRINOLOGISTS