Which oral antidiabetic drug to combine with metformin to minimize the risk of hypoglycemia when initiating basal insulin? A randomized controlled trial of a DPP4 inhibitor versus insulin secretagogues

摘要

We conducted a pilot study to evaluate two therapeutic strategies at the time of insulin initiation in type 2 diabetic patients insufficiently controlled with metformin + insulin-secretagogues (IS, sulfonylureas or glinides). Patients were randomized to remain under the same dual therapy or to receive metformin + DPP4 inhibitors while starting insulin. Similar glycemic control was achieved in both groups. However less hypoglycemia was observed with DPP4 inhibitors despite higher doses of insulin. (C) 2016 Elsevier Ireland Ltd. All rights reserved.