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When it is impossible to achieve the desired blood sugar with metformin monotherapy alone, they also recommend early active treatment for patients with type 2 diabetes early. For patients with T2D at high atherosclerotic cardiovascular disease and sodium-glucose cotransporter-2 inhibitor, the American Diabetes Association's recommendations recommend using glucagon-like peptide 1 receptor agonist and sodium-glucose cotransporter-2 inhibitor for T2D patients with a high risk of heart disease or chronic kidney disease. In fact, in a phase 3 clinical study of Koreans, glumepiride and metformin administration was more effective in the hypoglycemic effect, relative to increasing the dose of metformin. However, hypoglycemia became more frequent than metformin monotherapy when glimepiride and metformin were combined, and weight gain was a factor of weight gain, as seen in the case. DPP-4 inhibitor and metformin combination therapy may be the most preferred alternative over the sulfonylurea and metformin combination therapy, considering the risks connected to hypoglycemia's occurrence. In several phase 3 and registry studies in patients with T2D who failed metformin monotherapy, the introduction of a DPP-4 inhibitor to metformin was found to be safe in hypoglycemia as opposed to the addition of a sulfonylurea. Gemigliptin, a relatively new drug among DPP-4 inhibitors, is a relatively new product, and many clinical trials have reported findings that are similar to or superior to existing DPP-4 inhibitors, such as sitagliptin. Given the rise in hospitalizations as a result of heart disease in some DPP-4 inhibitor studies, an investigation into the direct effect of gemigliptin on heart function may be clinically relevant.
Source link: https://clinicaltrials.gov/ct2/show/NCT05663736
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