Triple Combination Therapy in Type 2 Diabetic Patients Who Had Inadequate Glycemic Control With Combination Therapy

Dual combination therapy with metformin and sulphonylurea is the most commonly used combination regimen to treat patients with type 2 diabetes. But, treatment with the dual combination therapy is often unsuccessful at achieving glycaemic control in patients with type 2 diabetes.

Recently, various oral hypoglycemic agents were developed including dipeptidyl peptidase (DPP)-IV inhibitor, sodium-glucose cotransporter 2 (SGLT2) inhibitor and new peroxisome proliferator-activated receptors (PPARs) agonists.

But, there have been few studies about the glucose lowering effect of these drugs in Type 2 diabetes patients on the dual combination therapy with a sulfonylurea agent and metformin.

Hence, the researchers plan to investigate the efficacy and safety of these drugs in combination with a sulfonylurea agent and metformin in type 2 diabetic patients.

Inclusion criteria

• 20 ≤ Age < 80 years
• HbA1c ≥ 7 %
• combination therapy with glimepiride and metformin over 2 months.
• dosage of glimepiride : 1-8mg/day
• dosage of metformin : 500-2550mg/day

Exclusion criteria

• Type 1 diabetes, gestational diabetes, or secondary forms of diabetes
• Contraindication to sitagliptin or dapagliflozin or lobeglitazone
• Pregnant or breast feeding women
• Medication which affect glycemic control (ex. steroid)
• Disease which affect efficacy and safety of drugs
• Any major illness (Liver disease, Renal failure, Heart disease, Cancer, etc)
• Not appropriate for oral antidiabetic agent