A saxagliptin/metformin combination and glipizide both improved glycemia and β-cell function in people with newly-diagnosed type 2 diabetes and severe hyperglycemia, according to an open-label, randomized controlled trial involving 100 individuals. Those taking the combination had less hypoglycemia.

Participants were randomized to receive saxagliptin 5 mg/metformin 2000 mg daily (Kombiglyze XR) or glipizide XL 10 mg daily. Among the results:

• Glucose declined to 137 mg/dL from 343 mg/dL in the combination group; and to 129 mg/dL from 341 mg/dL in the glipizide contingent.

• HbA1c declined to 6.8% from 10.8% in the combination group; and to 6.9% from 11% in the glipizide patients.

• HOMA-β-cell improved nearly 6-fold in both groups.

• Early-insulin-response improved nearly 10-fold in the combination group and more than 13-fold in those taking glipizide.

• Hypoglycemia was lower in the combination group, as were the number of hypoglycemia episodes.

The authors concluded that certain oral medications can serve as alternatives in treating severe hyperglycemia.

Citation: Amblee A, Lious D, Fogelfeld L. Combination of saxagliptin and metformin is effective as initial therapy in new onset type 2 diabetes mellitus with severe hyperglycemia. [Published online ahead of print May 4, 2015]. J Clin Endocrinol Metab. doi:10.1210/jc.2015-4097.