Glycemic Improvement with a Fixed‐dose combination of DPP‐4 inhibitor + metformin in patients with Type 2 diabetes (GIFT study)

This study investigates changes in A1C following a switch from dual therapy of metformin and DPP ‐4 inhibitor to a fixed‐dose combination ( FDC ) of metformin + DPP ‐4 inhibitor following the introduction of the FDC in the provincial formulary. The LMC D iabetes R egistry was queried retrospectively for patients with type 2 diabetes, aged between 18 and 80 years with at least one A1C recorded prior and ≥3 months post‐switch. Five hundred and sixty‐eight subjects with mean age 64 ± 12 years and mean A1C 7.7% ± 1.2% met study criteria. Overall, A1C was 0.3% lower post‐switch to FDC ( P < .01). In stratified analysis, subjects with baseline A1C between 7% and 10% had 0.4% lower A1C ( P < .01), with 31% of these subjects reaching target A1C ≤7%, post‐switch. A1C reduction was greater among patients with a higher baseline pill burden: 0.4% among those using ≥10 pills/day vs. 0.1% for those with <10 pills/day ( P = .02). In this real‐world study, switching to FDC of m etformin + DPP ‐4 inhibitor was associated with a significant improvement in A1C . Switching to FDC , especially in patients with high pill burden, can improve A1C goal achievement in clinical practice.