Combination of Linagliptin and Metformin for the Treatment of Patients with Type 2 Diabetes

Type 2 diabetes mellitus (T2DM) is a progressive condition requiring long-term treatment. Most patients with T2DM are unable to maintain normoglycemia using metformin alone; thus, combination therapy is a pivotal part of disease management. Addition of the dipeptidyl peptidase-4 inhibitor linagliptin, with its proven efficacy, low propensity for hypoglycemia, and weight neutrality, has been shown to improve glycemic control for patients who are not well controlled with metformin. As patients often have other comorbidities requiring pharmacotherapy, an increase in pill number, different prescribing frequencies, and timing of medications may adversely impact patients' adherence. Studies have shown that treatment nonadherence contributes to increased morbidity, mortality, and healthcare cost. In the United States, the single-pill combination (SPC) of linagliptin/metformin is available in three strengths approved for twice-daily administration: 2.5/500 mg, 2.5/850 mg, and 2.5/1000 mg. The SPC has the potential to reduce pill burden and simplify patients' treatment regimens, thereby promoting improved adherence and efficacy.