Drogowskazy terapeutyczne dla sitagliptyny Artykuł przeglądowy
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Opublikowane:
mar 1, 2026
Słowa kluczowe:
cukrzyca typu 2, sitagliptyna, metformina
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Abstrakt
Sitagliptyna jest selektywnym inhibitorem enzymu peptydazy DPP-4, którego naturalną rolą w organizmie jest szybki rozkład hormonów inkretynowych (GLP-1 i GIP). Dzięki zablokowaniu enzymu DPP-4 hormony inkretynowe dłużej pozostają w organizmie. Lek ma średnią siłę działania obniżającego glikemię i neutralnie wpływa na masę ciała. Zaletą sitagliptyny jest jej bezpieczeństwo – nie wywołuje ona ryzyka hipoglikemii. Jest najdokładniej przebadaną gliptyną pod względem skuteczności działania w różnych kombinacjach lekowych, tolerancji i bezpieczeństwa działania w różnych grupach chorych, zwłaszcza u osób starszych. Jest lekiem z wyboru u osób starszych z cukrzycą, z wysokim ryzykiem hipoglikemii oraz z ryzykiem nietolerancji leków. W zaleceniach sitagliptyna ma stabilną pozycję jako lek drugiego lub trzeciego rzutu. W artykule omówiono miejsce sitagliptyny w obecnych zaleceniach terapii cukrzycy typu 2.
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Jak cytować
Cyganek, K. (2026). Drogowskazy terapeutyczne dla sitagliptyny . Medycyna Faktów , 19(4(69), 499-503. https://doi.org/10.24292/01.MF.0425.03
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Bibliografia
1. Davies MJ, Aroda VR, Collins BS et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022; 65(12): 1925-66. https://doi.org/10.1007/s00125-022-05787-2.
2. American Diabetes Association Position Statement. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes – 2026 Diabetes Care. 2026; 45(Suppl. 48): S52-76. https://doi.org/10.2337/dc24-S004.
3. Araszkiewicz A, Bandurska-Stankiewicz E, Borys S et al. Standards of Care in Diabetes. The position of Diabetes Poland – 2025. Current Topics in Diabetes. 2025; 5(1): 1-158. https://doi.org/10.5114/ctd/203685.
4. Nauck MA. Unraveling the science of incretin biology. Am J Med. 2009; 122(6 Suppl): S3-S10. https://doi.org/10.1016/j.amjmed.2009.03.012.
5. Esposito K, Chiodini P, Maiorino MI et al. Glycaemic durability with dipeptidyl peptidase-4 inhibitors in type 2 diabetes: a systematic review and meta-analysis of long-term randomised controlled trials. BMJ. 2014; 4: e005442.
6. Sharma M, Beckley N, Nazareth I et al. Effectiveness of sitagliptin compared to sulfonylureas for type 2 diabetes mellitus inadequately controlled on metformin: a systematic review and meta-analysis. BMJ Open. 2017; 7: e017260. https://doi.org/10.1136/bmjopen-2017-017260.
7. Deng Y, Polley EC, Wallach JD et al. Comparative effectiveness of second line glucose lowering drug treatments using real world data: emulation of a target trial. BMJMED. 2023; 2: e000419. https://doi.org/10.1136/ bmjmed-2022-000419.
8. Goossen K, Graber S. Longer term safety of dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes mellitus: systematic review and meta-analysis. Diabetes Obes Metab. 2012; 14: 1061-72.
9. Janani L, Bamehr H, Tanha K et al. Effects of Sitagliptin as Monotherapy and Add-On to Metformin on Weight Loss among Overweight and Obese Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Drug Res. 2021; 71: 477-88.
10. Haddad F, Dokmak G, Bader M et al. A Comprehensive Review on Weight Loss Associated with Anti-Diabetic Medications. Life. 2023; 13: 1012. https://doi.org/10.3390/life13041012.
11. Kubota A, Maeda H, Kanamori A et al. Pleiotropic effects of sitagliptin in the treatment of type 2 diabetes mellitus patients. J Clin Med Res. 2012; 4: 309-13.
12. Shigematsu E, Yamakawa T, Kadonosono K et al. Effect of Sitagliptin on Lipid Profile in Patients With Type 2 Diabetes Mellitus. J Clin Med Res. 2014; 6(5): 327-35.
13. Monami M, Lamanna C, Desideri CM et al. DPP-4 inhibitors and lipids: systematic review and meta-analysis. Adv Ther. 2012; 29(1): 14-25.
14. Engel SS, Williams-Herman DE, Golm GT et al. Sitagliptin: review of preclinical and clinical data regarding incidence of pancreatitis. Int J Clin Pract. 2010; 64(7): 984-90.
15. Eurich D, Simpson S, Senthilselvan A et al. Comparative safety and effectiveness of sitagliptin in patients with type 2 diabetes: retrospective population based cohort study. BMJ. 2013; 346: f2267.
16. Arjona Ferreira JC, Marre M, Barzilai N et al. Efficacy and safety of sitagliptin versus glipizide in patients with type 2 diabetes and moderate-tosevere chronic renal insufficiency. Diabetes Care. 2013; 36(5): 1067-73.
17. Roussel R, Duran-Garcia S, Zhang Y at al. Double-blind, randomized clinical trial comparing the efficacy and safety of continuing or discontinuing the dipeptidyl peptidase-4 inhibitor sitagliptin when initiating insulin glargine therapy in patients with type 2 diabetes: The Compo-SIT-I Study. Diabetes Obes Metab. 2019; 21: 781-90.
18. Mesri Alamdari N, Barghaman M, Roshanravan N et al. Comparison of the effects of empagliflozin and sitagliptin, as an add-on to metformin, on cardio-metabolic and glycemic parameters of patients with type 2 diabetes mellitus: a randomized, double-blind clinical trial. BMC Res Notes. 2025; 18(1): 339. https://doi.org/10.1186/s13104-025-07214-2.
19. Lee KA, Jin HY, Kim YJ et al. Real-world comparison of mono and dual combination therapies of metformin, sulfonylurea, and dipeptidyl peptidase-4 inhibitors using a common data model: a retrospective observational study. Medicine. 2022; 101(8): e28823.
20. Elhini SH, Hussien AK, Omran AA et al. Efficacy and safety profile of sitagliptin, vildagliptin, and metformin in newly diagnosed type 2 diabetic subjects. Clin Exp Pharmacol Physiol. 2021; 48(12): 1589-602.
21. Hong JH, Moon JS, Seong K et al. Comparison of therapeutic efficacy and safety of sitagliptin, dapagliflozin, or lobeglitazone adjunct therapy in patients with type 2 diabetes mellitus inadequately controlled on sulfonylurea and metformin: Third agent study. Diabetes Res Clin Pract. 2023; 203: 110872. https://doi.org/10.1016/j.diabres.2023.110872.
22. Zakaraia HG, Salem HF, Mostafa MAA et al. Adding empagliflozin to sitagliptin plus metformin vs. adding sitagliptin to empagliflozin plus metformin as triple therapy in Egyptian patients with type 2 diabetes: a 12-week open trial. Eur Rev Med Pharmacol Sci. 2023; 27(15): 7289-98.
23. Yaribeygi H, Mirmohammadkhani M, Rashidy-Pour A et al. Addition of sitagliptin to ongoing metformin improved metabolic profile and pancreatic function via normalizing inflammatory cytokines’ levels in patients with type 2 diabetes, a randomized double-blinded clinical trial. Expert Rev Endocrinol Metab. 2025; 20(6): 623-31. https://doi.org/10.1080/17446651.2025.2539252.
24. Park Y-H, Sohn M, Lee SY et al. Two-Year Therapeutic Efficacy and Safety of Initial Triple Combination of Metformin, Sitagliptin, and Empagliflozin in Drug-Naïve Type 2 Diabetes Mellitus Patients. Diabetes Metab J. 2024; 48: 253-64. https://doi.org/10.4093/dmj.2023.0128.
25. De Luca M, Arcopinto M, Bosco G et al. Patterns and Clinical Outcomes of Sitagliptin/Metformin Extended-Release in Internal Medicine: A Real-World Multicenter Italian Study. J Clin Med. 2026; 15: 927. https://doi.org/10.3390/jcm15030927.
2. American Diabetes Association Position Statement. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes – 2026 Diabetes Care. 2026; 45(Suppl. 48): S52-76. https://doi.org/10.2337/dc24-S004.
3. Araszkiewicz A, Bandurska-Stankiewicz E, Borys S et al. Standards of Care in Diabetes. The position of Diabetes Poland – 2025. Current Topics in Diabetes. 2025; 5(1): 1-158. https://doi.org/10.5114/ctd/203685.
4. Nauck MA. Unraveling the science of incretin biology. Am J Med. 2009; 122(6 Suppl): S3-S10. https://doi.org/10.1016/j.amjmed.2009.03.012.
5. Esposito K, Chiodini P, Maiorino MI et al. Glycaemic durability with dipeptidyl peptidase-4 inhibitors in type 2 diabetes: a systematic review and meta-analysis of long-term randomised controlled trials. BMJ. 2014; 4: e005442.
6. Sharma M, Beckley N, Nazareth I et al. Effectiveness of sitagliptin compared to sulfonylureas for type 2 diabetes mellitus inadequately controlled on metformin: a systematic review and meta-analysis. BMJ Open. 2017; 7: e017260. https://doi.org/10.1136/bmjopen-2017-017260.
7. Deng Y, Polley EC, Wallach JD et al. Comparative effectiveness of second line glucose lowering drug treatments using real world data: emulation of a target trial. BMJMED. 2023; 2: e000419. https://doi.org/10.1136/ bmjmed-2022-000419.
8. Goossen K, Graber S. Longer term safety of dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes mellitus: systematic review and meta-analysis. Diabetes Obes Metab. 2012; 14: 1061-72.
9. Janani L, Bamehr H, Tanha K et al. Effects of Sitagliptin as Monotherapy and Add-On to Metformin on Weight Loss among Overweight and Obese Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Drug Res. 2021; 71: 477-88.
10. Haddad F, Dokmak G, Bader M et al. A Comprehensive Review on Weight Loss Associated with Anti-Diabetic Medications. Life. 2023; 13: 1012. https://doi.org/10.3390/life13041012.
11. Kubota A, Maeda H, Kanamori A et al. Pleiotropic effects of sitagliptin in the treatment of type 2 diabetes mellitus patients. J Clin Med Res. 2012; 4: 309-13.
12. Shigematsu E, Yamakawa T, Kadonosono K et al. Effect of Sitagliptin on Lipid Profile in Patients With Type 2 Diabetes Mellitus. J Clin Med Res. 2014; 6(5): 327-35.
13. Monami M, Lamanna C, Desideri CM et al. DPP-4 inhibitors and lipids: systematic review and meta-analysis. Adv Ther. 2012; 29(1): 14-25.
14. Engel SS, Williams-Herman DE, Golm GT et al. Sitagliptin: review of preclinical and clinical data regarding incidence of pancreatitis. Int J Clin Pract. 2010; 64(7): 984-90.
15. Eurich D, Simpson S, Senthilselvan A et al. Comparative safety and effectiveness of sitagliptin in patients with type 2 diabetes: retrospective population based cohort study. BMJ. 2013; 346: f2267.
16. Arjona Ferreira JC, Marre M, Barzilai N et al. Efficacy and safety of sitagliptin versus glipizide in patients with type 2 diabetes and moderate-tosevere chronic renal insufficiency. Diabetes Care. 2013; 36(5): 1067-73.
17. Roussel R, Duran-Garcia S, Zhang Y at al. Double-blind, randomized clinical trial comparing the efficacy and safety of continuing or discontinuing the dipeptidyl peptidase-4 inhibitor sitagliptin when initiating insulin glargine therapy in patients with type 2 diabetes: The Compo-SIT-I Study. Diabetes Obes Metab. 2019; 21: 781-90.
18. Mesri Alamdari N, Barghaman M, Roshanravan N et al. Comparison of the effects of empagliflozin and sitagliptin, as an add-on to metformin, on cardio-metabolic and glycemic parameters of patients with type 2 diabetes mellitus: a randomized, double-blind clinical trial. BMC Res Notes. 2025; 18(1): 339. https://doi.org/10.1186/s13104-025-07214-2.
19. Lee KA, Jin HY, Kim YJ et al. Real-world comparison of mono and dual combination therapies of metformin, sulfonylurea, and dipeptidyl peptidase-4 inhibitors using a common data model: a retrospective observational study. Medicine. 2022; 101(8): e28823.
20. Elhini SH, Hussien AK, Omran AA et al. Efficacy and safety profile of sitagliptin, vildagliptin, and metformin in newly diagnosed type 2 diabetic subjects. Clin Exp Pharmacol Physiol. 2021; 48(12): 1589-602.
21. Hong JH, Moon JS, Seong K et al. Comparison of therapeutic efficacy and safety of sitagliptin, dapagliflozin, or lobeglitazone adjunct therapy in patients with type 2 diabetes mellitus inadequately controlled on sulfonylurea and metformin: Third agent study. Diabetes Res Clin Pract. 2023; 203: 110872. https://doi.org/10.1016/j.diabres.2023.110872.
22. Zakaraia HG, Salem HF, Mostafa MAA et al. Adding empagliflozin to sitagliptin plus metformin vs. adding sitagliptin to empagliflozin plus metformin as triple therapy in Egyptian patients with type 2 diabetes: a 12-week open trial. Eur Rev Med Pharmacol Sci. 2023; 27(15): 7289-98.
23. Yaribeygi H, Mirmohammadkhani M, Rashidy-Pour A et al. Addition of sitagliptin to ongoing metformin improved metabolic profile and pancreatic function via normalizing inflammatory cytokines’ levels in patients with type 2 diabetes, a randomized double-blinded clinical trial. Expert Rev Endocrinol Metab. 2025; 20(6): 623-31. https://doi.org/10.1080/17446651.2025.2539252.
24. Park Y-H, Sohn M, Lee SY et al. Two-Year Therapeutic Efficacy and Safety of Initial Triple Combination of Metformin, Sitagliptin, and Empagliflozin in Drug-Naïve Type 2 Diabetes Mellitus Patients. Diabetes Metab J. 2024; 48: 253-64. https://doi.org/10.4093/dmj.2023.0128.
25. De Luca M, Arcopinto M, Bosco G et al. Patterns and Clinical Outcomes of Sitagliptin/Metformin Extended-Release in Internal Medicine: A Real-World Multicenter Italian Study. J Clin Med. 2026; 15: 927. https://doi.org/10.3390/jcm15030927.