Glycemic Improvement with a Fixed‐dose combination of DPP‐4 inhibitor + metformin in patients with Type 2 diabetes (GIFT study)

• Published in: Diabetes, obesity & metabolism Vol. 20; no. 1; pp. 195 - 199
• Main Authors: Bajaj, Harpreet S., Ye, Chenglin, Jain, Esha, Venn, Karri, Stein, Eden, Aronson, Ronnie
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2018; Wiley Subscription Services, Inc
• Subjects: adherence; Aged; Antidiabetics; Cohort Studies; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Dipeptidyl-Peptidase IV Inhibitors - administration & dosage; Dipeptidyl-Peptidase IV Inhibitors - adverse effects; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use; DPP‐4 inhibitor; Drug Combinations; Drug Monitoring; Drug Therapy, Combination - adverse effects; Female; fixed‐dose combination; Formularies as Topic; Glycated Hemoglobin A - analysis; Humans; Hyperglycemia - prevention & control; Hypoglycemia - chemically induced; Hypoglycemia - prevention & control; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Male; Medication Adherence; Metformin; Metformin - administration & dosage; Metformin - adverse effects; Metformin - therapeutic use; Middle Aged; Ontario; Patient compliance; Registries; Retrospective Studies; State Medicine; type 2 diabetes; type 2 diabetes; fixed-dose combination; DPP-4 inhibitor; adherence
• ISSN: 1462-8902; 1463-1326; 1463-1326
• DOI: 10.1111/dom.13040

This study investigates changes in A1C following a switch from dual therapy of metformin and DPP‐4 inhibitor to a fixed‐dose combination (FDC) of metformin + DPP‐4 inhibitor following the introduction of the FDC in the provincial formulary. The LMC Diabetes Registry was queried retrospectively for patients with type 2 diabetes, aged between 18 and 80 years with at least one A1C recorded prior and ≥3 months post‐switch. Five hundred and sixty‐eight subjects with mean age 64 ± 12 years and mean A1C 7.7% ± 1.2% met study criteria. Overall, A1C was 0.3% lower post‐switch to FDC (P < .01). In stratified analysis, subjects with baseline A1C between 7% and 10% had 0.4% lower A1C (P < .01), with 31% of these subjects reaching target A1C ≤7%, post‐switch. A1C reduction was greater among patients with a higher baseline pill burden: 0.4% among those using ≥10 pills/day vs. 0.1% for those with <10 pills/day (P = .02). In this real‐world study, switching to FDC of metformin + DPP‐4 inhibitor was associated with a significant improvement in A1C. Switching to FDC, especially in patients with high pill burden, can improve A1C goal achievement in clinical practice.