Am Fam Physician. 2015 Dec 1;92(11):1020a-1021.
Does adding sitagliptin (Januvia) to existing therapy for type 2 diabetes mellitus improve outcomes?
The glass half full is that sitagliptin does not increase the risk of cardiovascular events in patients with type 2 diabetes. The glass half empty is that it does not reduce the risk, either. And that is the important message: In patients with a mean glycated hemoglobin level of 7.2%, adding sitagliptin at a cost of approximately $350 per month does not affect cardiovascular outcomes at all. (Level of Evidence = 1b)
To date, the only drug shown to reduce the risk of cardiovascular events or death in patients with type 2 diabetes is metformin. Sitagliptin is one of a class of dipeptidyl-peptidase-4 inhibitors that reduces glucose levels by decreasing glucagon levels and increasing insulin secretion. A previous meta-analysis found a 25% relative increase
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