Sitagliptin and Glucagon Counterregulation

The glucagon response to mild (3.0 mmol/l) hypoglycemia with and without DPP-4 inhibition by sitagliptin will be evaluated in elderly subjects with metformin treated type 2 diabetes to explore whether DPP-4 inhibition affects glucagon counter-regulation.

Inclusion criteria

• Written consent has been given.
• Patients with metformin treated T2DM (metformin dose >0,5 g/day and stable during the preceding 3 months)
• Age >65 years.
• HbA1c 6.0-8.5% (43-67 mmol/mol; inclusive) at visit 1.
• Ability to complete the study

Exclusion criteria

• A history of any secondary forms of diabetes, e.g., Cushing's syndrome and acromegaly.
• Type 2 diabetes, positive GAD antibodies
• eGFR <60 ml/min
• Acute infections which may affect blood glucose control within 4 weeks prior to visit 1
• Any history of recent (<2 weeks) recurrent or severe hypoglycemic episodes.
• Liver disease such as cirrhosis or chronic active hepatitis
• History of coronary heart disease or heart failure class III or IV
• Donation of one unit (500 ml) or more of blood, significant blood loss equaling to at least one unit of blood within the past 2 weeks or a blood transfusion within the past 8 weeks.
• Treatment with growth hormone of chronic oral or parenteral corticosteroid treatment (> 7 consecutive days of treatment) within 8 weeks prior to visit 1.
• Use of other investigational drugs at visit 1 or within 30 days of visit 1, unsuitable for the study