(HealthDay News) — For patients with type 2 diabetes mellitus (T2DM) treated with metformin, add-on sitagliptin is associated with a lower risk of insulin initiation than add-on sulphonylurea, according to a study published in Diabetes, Obesity and Metabolism.

Silvio E. Inzucchi, M.D., from the Yale University School of Medicine in New Haven, Conn., and colleagues conducted a retrospective cohort study to examine time to insulin initiation among patients with T2DM treated with sitagliptin versus sulphonylurea as an add-on to metformin. Participants were aged 18 years and older with continuous medical records and an initial prescription of sitagliptin or sulphonylurea with metformin for 90 days or more during 2006 to 2013. A total of 3,864 propensity-score-matched pairs were analyzed.

The researchers found that the risk of insulin initiation was lower for sitagliptin users versus sulphonylurea users over 6 years (26.6 versus 34.1%). After adjustment for baseline characteristics, the findings persisted (hazard ratio, 0.76; 95% confidence interval, 0.65 to 0.9). Compared with sulphonylurea users, sitagliptin users were less likely to initiate insulin in conditional logistic regression analyses.

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“In this real-world matched cohort study, patients with T2DM treated with sitagliptin had a significantly lower risk of insulin initiation compared with patients treated with sulphonylurea, both as add-on to metformin,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Merck, the manufacturer of sitagliptin.


  1. Inzucchi1, SE; Tunceli, K; Qiu, Y; et al. Diabetes, Obesity and Metabolism; doi: 10.1111/dom.12489.