Comparing the combination sitagliptin/metformin with glimepiride/metformin

In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) last looked into the advantages and disadvantages of sitagliptin (trade name: Januvia or Xelevia) compared with the standard treatments for type 2 diabetes in adults.

The results of two studies comparing the combination sitagliptin/metformin with glimepiride/metformin were available for analysis. The assessment was based mainly on the longer-lasting of the two studies.

What are the advantages of the combination sitagliptin/metformin?

  • Symptomatic hypoglycemia: The study suggests that symptomatic hypoglycemia was less common with sitagliptin/metformin than it was with glimepiride/metformin. About 22 out of 100 people who took glimepiride/metformin had hypoglycemia (blood sugar levels below 70 mg/dl) that also caused symptoms. In the group of people who took sitagliptin/metformin, about 3 out of 100 had this kind of hypoglycemia.

No difference

  • Life expectancy and complications: There was no difference between sitagliptin/metformin and glimepiride/metformin here. But there was little data available for this comparison.
  • Severe hypoglycemia: Severe hypoglycemia was equally uncommon in both groups. There was no difference between the two drug combinations.
  • Pancreatic , kidney dysfunction and severe side effects: There was no difference between the two drug combinations here.
  • Treatment stopped due to side effects: The analysis of the longer study showed no differences here.

What remains unanswered?

  • Quality of life: Due to a lack of conclusive data, it isn't possible to say whether there are any differences between the two treatment groups here.

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Sitagliptin – Benefit assessment according to §35a Social Code Book V; Dossier assessment; Commission A13-02. June 27, 2013. (IQWiG reports; Volume 175).

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Sitagliptin – Benefit assessment according to §35a Social Code Book V; Dossier assessment; Commission A16-44. September 30, 2016. (IQWiG reports; Volume 444).

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Sitagliptin – Benefit assessment according to §35a Social Code Book V; Dossier assessment; Commission A18-65. December 19, 2018. (IQWiG reports; Volume 693).

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on January 17, 2019
Next planned update: 2022

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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