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Aim: Baseline glycated hemoglobin (HbA1c) is critical in assessing anti-diabetic agent efficacy due to its ability to alter the response of HbA1c reduction to dipeptidyl peptidase-IV (DPP-IV) inhibitors. With meta-regression, we aim to investigate the quantitative relationship between baseline HbA1c levels and HbA1c reduction in response to sitagliptin as a monotherapy or metformin + sitagliptin as dual therapy. Additionally, we intend to study the slope difference between monotherapy and dual therapy. Method: We conducted an electronic search for randomized controlled trials (RCTs) involving monotherapy (sitagliptin) and dual therapy (sitagliptin and metformin) in type 2 diabetes patients. We analyzed quantitative relationships between baseline HbA1c and the change of HbA1c using meta-regression models. Results: The mean baseline HbA1c levels ranged from 7.54 (SE = 0.85) to 9.00 (SE = 1.4) for monotherapy and 7.48 (SE = 0.72) to 9.90 (SE = 1.8) for dual therapy respectively. According to metaregression models, the slopes of meta-regression lines were -0.198 (95% CI [-0.324, -0.072], p = 0.002) for monotherapy and -0.656 (95% CI [-0.925, -0.390], p < 0.001) for dual therapy, respectively. Conclusions: The association between baseline HbA1c and the HbA1c change differed between monotherapy and dual therapy. Therefore, the effect of baseline HbA1c level on HbA1c changes during monotherapy or dual therapy should be considered when assessing the clinical efficacy of diabetes therapies.

international journal of diabetes and clinical research

Quantitative Models for Evaluating the Correlation between Baseline Hba1c Levels and Sitagliptin as Monotherapy or Dual Therapy Treatment in Type 2 Diabetes: A Meta-Regression Analysis