ISSUE 1367
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Linagliptin (Tradjenta – Boehringer Ingelheim/Lilly), a third oral dipeptidyl peptidase-4 (DPP-4) enzyme inhibitor, was recently approved by the FDA for treatment of type 2 diabetes, either alone or in combination with metformin, a sulfonylurea or pioglitazone.
DRUGS FOR DIABETES — Metformin (Glucophage, and others) is generally preferred as the first-line oral hypoglycemic agent. A sulfonylurea, such as glimepiride (Amaryl, and others), is less likely than metformin to be effective as monotherapy and may cause weight gain and hypoglycemia. The thiazolidinedione pioglitazone (Actos) is effective for glycemic control, but can also cause weight gain, increases the risk of heart failure and was recently removed from the market in France and Germany because of concerns about an association with bladder cancer. If the desired glycated hemoglobin (A1C) goal is not achieved with metformin,
... more1. DM Nathan et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2009; 32:193.
2. Sitagliptin (Januvia) for type 2 diabetes. Med Lett Drugs Ther 2007; 49:1.
3. Saxagliptin (Onglyza) for type 2 diabetes. Med Lett Drugs Ther 2009; 51:85.
8. AJ Lewin et al. Safety and efficacy of linagliptin as add-on therapy to a sulphonylurea in inadequately controlled type 2 diabetes. European Association for the Study of Diabetes (EASD) 46th Annual Meeting; Stockholm, Sweden Sep 20-24, 2010; Poster No. 821-P.
9. DR Owens et al. Linagliptin improves glycemic control in type 2 diabetes patients inadequately controlled by metformin and sulfonylurea without weight gain and low risk of hypoglycemia. American Diabetes Association 70th Scientific Sessions, Orlando, Florida, June 25-29, 2010; Poster No. 548-P.

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