Comparing the Safety and Efficacy of Vildagliptin and Dapagliflozin as an Add on Therapy to Metformin in Patients with Type 2 Diabetes Mellitus (Research Article)

Author(s): Haritha Thambi B.S, Jayalakshmi Venugopal, Vimalan. V. S, Jaishree Suresh, Hari Haran. S, Shankar Dhandapani2

Abstract: Background: Metformin is the first-line therapy for type 2 diabetes (T2D). Vildagliptin is a new oral antidiabetic drug that improves pancreatic islet cell reactions to glucose. Dapagliflozin is used with an appropriate diet and exercise plan to control high blood sugar in people with T2D. The combination therapy for T2D needs to be explored to improve the treatment strategy. Aim: In this study, we assessed the safety and efficacy of Vildagliptin and Dapagliflozin as an add-on therapy to Metformin in patients with T2D. Materials and methods: A Quasi-Experimental study conducted with 109 T2D patients was randomly assigned to Metformin plus Vildagliptin (n=56) or Metformin plus Dapagliflozin (n=53) for six months. Cardiometabolic parameters were collected at baseline and the end of treatment, and adverse events also monitored and recorded. The statistical analyses were performed using Microsoft Excel 2019 software. Results: Mean age of patients was 55.62 ± 8.1 years (Males 65.14%). Baseline characteristics did not differ between the two groups. After 6 months of follow-up, HbA1C significantly decreased in both Vildagliptin and Dapagliflozin groups (7.34 ± 0.20 % and 7.80 ± 0.35%, respectively). The systolic and Diastolic blood pressure was observed more or less similar in both treatment groups. Vildagliptin as an add-on therapy to Metformin result in a clinically meaningful reduction in the mean difference in Fasting Blood Sugar (FBS) 58.96 mg/dL and Postprandial blood sugar (PPBS) 104.11 mg/dL without an incidence of hypoglycaemia when compared with Dapagliflozin + Metformin. Vildagliptin with Metformin was observed with no incidence of serious adverse events when compared with Dapagliflozin therapy. Conclusions: Vildagliptin as an add-on therapy to Metformin observed more favourable effects on efficacy and safety perspective when compared to Dapagliflozin combination therapy for the treatment of T2DM.

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