Insulin plus incretin: A glucose-lowering strategy for type 2-diabetes

Table 2 Published clinical trials with dipeptidyl peptidase-4 inhibitors combined with basal ± prandial insulin

		Vildagliptin		Sitagliptin		Alogliptin	Saxagliptin	Linagliptin
Ref		62	63	64	65	67	69	70
Number of patients		296	449	641	124	390	455	1261
Study duration (wk)		24	24	24	24	26	52	24
Comparator		Stable insulin	Stable insulin	Stable insulin	Increasing insulin	Stable insulin	Stable insulin	Stable insulin
HbA1c (%)	Baseline	8.4 ± 1.0	8.8 ± 1.0	8.7 ± 0.9	9.2 ± 1.0	9.3 ± 1.1	8.7 ± 0.9	8.3 ± 0.1
	Change	-0.5 ± 0.1	-0.8 ± 0.1	-0.6 (-0.7, -0.5)	-0.6 (-0.9, -0.3)	-0.7	-0.8 ± 0.1	-0.6 ± 0.1
	Baseline placebo	8.4 ± 1.1	8.8 ± 1.0	8.6 ± 0.9	9.2 ± 1.1	9.3 ± 1.1	8.6 ± 0.9	8.3 ± 0.1
	Change placebo	-0.2 ± 0.1	-0.1 ± 0.1	0 (-0.1, 0.1)	-0.2 (-0.5, 0.3)	-0.1	-0.4 ± 0.1	-0.1 ± 0.1
FPG (mmol/L)	Baseline	9.3 ± 3.1	9.6 ± 2.6	9.8 ± 2.9	9.0 ± 3.3	10.3 ± 3.9	NR	8.2 ± 2.6
	Change	-0.8 ± 0.3	-0.8	-1.0 (-1.4, -0.7)	-1.0 (-2.7, -0.2)	-0.6 ± 0.3		-0.2 ± 0.2
	Baseline placebo	8.7 ± 3.1	9.1 ± 2.5	9.9 ± 3.3	8.4 ± 2.8	10.9 ± 4.3	NR	8.4 ± 2.6
	Change placebo	-0.2 ± 0.4	-0.2	-0.2 (-0.6, 0.2)	-1.3 (-1.8, -0.5)	0.3 ± 0.3		-0.3 ± 0.2
Hypoglycemia		1131	8.42	162	72	202	232	232
Hypoglycemia placebo		1851	7.22	82	142	402	272	222
Body weight (kg)	Baseline	95 ± 2	78 ± 16	87 ± 19	69 ± 12	87 ± 19	88 ± 18	BMI (31 ± 5)
	Change	1.3 ± 0.3	0.1	-0.1 (-0.2, 0.4)	-0.7 (-1.4, -0.1)	0.6 ± 0.2	0.8	-0.2 ± 0.1
	Baseline placebo	95 ± 2	79 ± 17	87 ± 18	66 ± 10	91 ± 21	86 ± 16	BMI (31 ± 5)
	Change placebo	0.6 ± 0.3	-0.4	-0.1 (-0.3, 0.4)	1.1 (0.2, 1.8)	0.6 ± 0.2	0.5	0.1 ± 0.1

In the studies long and medium acting insulin and premixed insulins were used. Occurrence of hypoglycemia was reported as number of events¹ or as percentage of patients with at least one hypoglycemic episode². Variation in baseline is SD, variation in effect is SE. Variation within parenthesis is the 95%CI. FPG: Fasting glucose; BMI: Body mass index (kg/m²); HbA1c: Hemoglobin A1c.