Abstract
The results of large recent clinical studies have shown that it is necessary to strive for safe compensation without increasing the risk of hypoglycemia. The need to individualize treatment, minimize the risk of hypoglycemia and the progressive nature of the disease raise the intense need to seek new therapeutic options.
Incretins are hormones secreted by intestinal cells in response to a prandial stimulus. The main mechanisms by which glucose homeostasis is affected are glycemic-dependent insulin secretion, postprandial suppression of glucagon secretion, and gastric evacuation.
The most clinically important is glucagon-like peptide 1. It is degraded by the enzyme dipeptidyl peptidase IV (DPP IV).
The potential of incretins is used therapeutically either in the form of so-called incretin mimetics (exenatide, has the same effect but is resistant to enzymatic degradation, injected) or by inhibition of DPP IV (gliptins, ultimately increase the level of endogenous GLP 1). Sitagliptin is the first registered gliptin to demonstrate safety and efficacy in clinical trials and practice.
It was found that in combination with metformin, its effect is synergistic, ie higher than the simple sum of the effects of both drugs separately. Given the clinical efficacy and safety of the combination of sitaglitpine and metformin, this appears to be very beneficial for the treatment of type 2 diabetes.
There is a fixed combination of both substances before being placed on the market.