Therapeutic Efficacy and Glycemic Outcomes of Sitagliptin versus Pioglitazone as Add-on Therapies in Type 2 Diabetes Mellitus

International Journal of Medicine and Medical Sciences | Vol. 14, No. 4, April 2024 | pp. 25–32

DOI: 10.46882/2024/IJMMS/140025

Original Research Article

Therapeutic Efficacy and Glycemic Outcomes of Sitagliptin versus Pioglitazone as Add-on Therapies in Type 2 Diabetes Mellitus

Fatima Z. Bello¹, Kwaku A. Mensah², Grace N. Ojo¹*

¹Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria.

²Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract:

When metformin monotherapy fails to maintain glycemic targets in type 2 diabetes mellitus (T2DM), selecting an appropriate second-line agent is necessary to optimize clinical outcomes. This randomized, open-label, comparative clinical trial evaluated the therapeutic efficacy, safety, and metabolic profiles of sitagliptin versus pioglitazone as add-on therapies in patients with inadequately controlled T2DM. A total of 150 adult patients with baseline Glycated Hemoglobin (HbA1c) between 7.5% and 9.5% despite optimal metformin therapy were randomized to receive either sitagliptin (100 mg daily, n = 75) or pioglitazone (30 mg daily, n = 75) for 24 weeks. The primary outcome was the mean reduction in HbA1c at week 24, while secondary outcomes tracked fasting plasma glucose (FPG), lipid parameters, and body weight variations. At the completion of 24 weeks, both treatment arms demonstrated significant reductions in HbA1c from baseline markers (p < 0.01). The mean decrease in HbA1c was comparable between the sitagliptin group (-0.84 ± 0.15%) and the pioglitazone cohort (-0.92 ± 0.18%, p = 0.42). Pioglitazone achieved a significantly greater reduction in mean FPG and a significant increase in HDL-cholesterol levels compared to sitagliptin (p < 0.05). However, sitagliptin demonstrated superior safety regarding body weight modifications, showing a slight mean weight reduction (-0.48 ± 0.22 kg) compared to a significant weight gain in the pioglitazone arm (+2.45 ± 0.64 kg, p < 0.001). Mild peripheral edema was reported exclusively in the pioglitazone cohort (10.7%). Both options offer similar glycemic efficacy, but sitagliptin provides advantages for weight management, whereas pioglitazone offers specific lipid benefits.

Keywords: Type 2 Diabetes Mellitus, Sitagliptin, Pioglitazone, HbA1c, Weight Modification, Metabolic Profiles

Manuscript Timeline: Received: January 12, 2024; Revised: February 20, 2024; Accepted: March 15, 2024; Published: April 16, 2024.

Citation: Bello FZ, Mensah KA, Ojo GN. Therapeutic Efficacy and Glycemic Outcomes of Sitagliptin versus Pioglitazone as Add-on Therapies in Type 2 Diabetes Mellitus. International Journal of Medicine and Medical Sciences, 2024, 14(4): 25–32. DOI: 10.46882/2024/IJMMS/140025

Subscribe to read the full article: https://internationalscholarsjournals.org/subscribe-to-read