OBJECTIVES: Diabetes mellitus is a pressing medical and social problem of modern society, which is among the top 4 non-communicable diseases causing a considerable number of deaths every year. Our purpose was to evaluate the effectiveness of vildagliptin in adult patients with type 2 diabetes undergoing metmorfin monotherapy with unsatisfactory glycemic control.

METHODS: RESULTS: Credible evidence for advantages of using vildagliptin in combination with metmorfin for improving glycemic control in comparison to other DPP-4 inhibitors, regardless of base level of HbA1c, age or BMI, has been identified. Combination therapy using 50 mg of vildagliptin and metmorfin twice per day significantly decreased the average base level of HbA1c (by -0.7 to -0.9%) and fasting blood glucose level (from -1.4 to 0.1 mmol/l) compared to placebo group and other DPP-4 inhibitors. This combination also resulted in the highest increase in QALYs (0.18) among DPP-4 inhibitors compared to treatment using a combination of metmorfin and glimepiride.

CONCLUSIONS: Combination therapy using metmorfin and vildagliptin has advantages in effectiveness and additional mechanisms of action, since it does not increase the risk of hypoglycemia and does not lead to increasing weight.