Vildagliptin Versus Dapagliflozin on Glucagon

The aim of the study is to assess if vildagliptin and dapagliflozin have dissociated effects on glucagon secretion after a mixed meal ingestion in metformin-treated subjects with type 2 diabetes and whether this is associated with effects on glucose homeostasis. Subjects will therefore be treated with vildagliptin or dapagliflozin as add-on to metformin for two weeks followed by a meal test in which glucagon levels will be determined.

Inclusion criteria

• Written consent has been given.
• Patients with type 2 diabetes treated with a stable dose of metformin during the last three months
• Age 20-70 years.
• HbA1c 6.5-8.5% (48-67 mmol/mol) at visit 1.
• Ability to complete the study

Exclusion criteria

• Use of other glucose-lowering therapy than metformin within three months prior to visit 1.
• A history of any secondary forms of diabetes, e.g., Cushing's syndrome and acromegaly.
• Type 1 diabetes, positive GAD antibodies
• Estimated glomerular filtration rate <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.
• Any history of acute pancreatitis
• Any history of anaphylaxis, angioedema, and exfoliative skin conditions including Stevens-Johnson syndrome.
• 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
• Hypersensitivity to vildagliptin or dapagliflozin or any compound in the tablet core