The dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin improves glycaemic control in patients with type 2 diabetes mellitus. In Europe vildagliptin is indicated for use in patients with type 2 diabetes inadequately controlled by lifestyle measures plus an oral antidiabetic drug (OAD) — metformin, a sulphonylurea or a thiazolidinedione. This audit examined the effects of vildagliptin added to one, two or three other OADs (in 13, 12 and five patients, respectively). Glycated haemoglobin A1C (HbA1C) was reduced in 70% of patients (61.5%, 75% and 80% on dual, triple and quadruple therapy, respectively). Mean HbA 1C level decreased from 8.9% to 7.9% (p=0.012). The largest reduction was in African-Caribbean patients (-1.3%). No significant changes in weight, blood pressure or liver function occurred.
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