Comparing Vildagliptin SR 100mg and Teneligliptin 20mg in Type 2 Diabetes Study

Description

Abstract (English)

Abstract
Diabetes Mellitus is an entity of considerable morbidity comprising a spectrum of multisystem dysfunctions
stemming from the combination of insulin resistance and inadequate insulinsecretion. Management of diabetes,
akin to a tightrope walk, requires a comprehensive understanding of various factors such as over-all clinical
picture, adverse effect profile, the complex of inter-play of drugs, etc. More than two-thirds of people with type
2 diabetes will eventually require more than one oral agent, with or without insulin. Diabetes is emerging as a
global epidemic, imposing enormous humanitarian and economic burdens on society. According to a WHO
projection, by 2030, approximately 190 million people will be affected in the Asia-Pacific region alone.
Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals
currently diagnosed with the disease. Evidence suggests that patients with type 2 diabetes mellitus (T2DM)
increasingly require multiple pharmacological combinations to reach treatment goals. Clinical inertia, with
failure to advance therapy despite persistently elevated HbA1c levels above target, has become a major
problem for the stepwise approach to treatment. Initial combination therapy using two oral anti-diabetic drugs
(OAD) with complementary mechanisms of action is an alternative approach that may provide better or more
sustained glycemic control. It may also allow the useof lower doses of the component OADs and thus minimize
any dose-related adverse events (AEs). Vildagliptin is a selective and reversible inhibitor of Dipeptidyl
peptidase 4 (DPP-4), the enzyme which inactivates the incretin hormones, glucagon-like peptide-1 (GLP-1), and
glucose-dependent insulinotropic polypeptide (GIP), hormones which significantly contribute to the
maintenance of glucose homeostasis. Vildagliptin improved glycaemic control when given as monotherapy or
when used in combination with Metformin, a sulphonylurea, and a thiazolidinedione, as measured by clinically
relevant reductions in HbA1c from baseline at study endpoint. In clinical trials, the magnitude of HbA1c
reductions with Vildagliptin was greater in patients with higher baseline HbA1c.