title: Patient considerations and clinical utility of a fixed dose combination of saxagliptin/metformin in the treatment of type 2 diabetes.
abstract: BACKGROUND
  Targeting glycated hemoglobin (HbA(1c)) levels below 7.0% is considered a primary goal of diabetes care, given its importance in obtaining a sustained reduction in microvascular, and possibly macrovascular complications.
  
  
  OBJECTIVE
  The aim of this review was to evaluate the clinical utility of a fixed dose combination of saxagliptin/metformin in the treatment of type 2 diabetes.
  
  
  METHODS
  The combination of saxagliptin/metformin was well tolerated and produced sustained glycemic control for up to 76 weeks, with greater improvements in glycemic parameters compared with either drug alone. The saxagliptin/metformin combination also proved its non-inferiority compared with either sulfonylurea/metformin or sitagliptin/metformin combinations.
  
  
  CONCLUSIONS
  Clinical practice recommends lifestyle interventions together with starting metformin at the time that the type 2 diabetes mellitus is diagnosed. Once metformin fails to maintain glycemic control, the addition of DPP-4 inhibitors should be the logical choice because of their effects on HbA(1c) compared to the addition of a sulfonylurea or glitazone, and because of their positive effects on beta cell function and their neutral effects on body weight. Furthermore, DPP-4 inhibitors prevent the risk of hypoglycemia posed by sulfonylureas.
authors.affiliation: Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Derosa
authors.forename: Pamela
authors.initials: P
authors.lastname: Maffioli