Comparing the combination sitagliptin/metformin with glipizide/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 one study comparing the combination sitagliptin/metformin with glipizide/metformin were available for analysis. The drug glipizide has not been approved for use in Germany. The following results apply only to patients for whom the aim of treatment with medication is to lower blood sugar levels as much as possible.

What are the advantages of the combination sitagliptin/metformin?

  • Life expectancy: The study suggests that sitagliptin/metformin has an advantage compared with glipizide/metformin here. 1 out of 588 patients died in the group that took sitagliptin/metformin. In the group that used glipizide/metformin, 7 out of 584 people died.
  • Symptomatic and severe hypoglycemia: The study suggests that hypoglycemia was less common with sitagliptin/metformin than it was with glipizide/metformin. This was also true for severe hypoglycemia that required medical treatment.

No difference

  • Complications: The combination sitagliptin/metformin wasn't found to have any advantages over glipizide/metformin here. This was based on very little available data, though.
  • Severe side effects and stopping treatment early: Most patients experienced side effects regardless of which of the two combinations they used. Overall, there was no difference between the two treatment groups in terms of severe side effects or the number of times treatment was stopped early.

What remains unanswered?

  • Quality of life: The study didn't look into effects on quality of life.

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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