<b>Dapagliflozin and Metformin Versus Sitagliptin and Metformin: A Battle for Better Glycemic Control in Type 2 Diabetes Mellitus</b>

Background: Type 2 diabetes mellitus (T2DM) is a globally prevalent metabolic disorder requiring combination therapies for optimal glycemic control. Among oral agents, dapagliflozin and sitagliptin are commonly used as add-on treatments to metformin, but comparative efficacy data in South Asian populations remain limited. Objective: To compare the efficacy of dapagliflozin versus sitagliptin when combined with metformin in achieving glycemic control and weight reduction in patients with T2DM. Methods: In this randomized clinical trial, 60 adult patients with uncontrolled T2DM (HbA1c >7.5%) were randomly assigned to receive either dapagliflozin 10 mg plus metformin 850 mg twice daily (Group A) or sitagliptin 100 mg plus the same metformin regimen (Group B) for 12 weeks. Primary outcomes included change in HbA1c, fasting blood glucose (FBS), postprandial blood glucose (PPBS), and weight. Target achievement of HbA1c <7% and ≥3% weight reduction were assessed. Results: Group A showed greater reductions in HbA1c (−1.40% vs −0.91%, p<0.001), FBS (−28.00 vs −20.83 mg/dL, p=0.032), PPBS (−70.93 vs −53.83 mg/dL, p=0.029), and weight (−2.85 vs −2.11 kg, p=0.041). More patients in Group A achieved HbA1c <7% (76.7% vs 50%, p=0.032) and ≥3% weight loss (80% vs 50%, p=0.015). Conclusion: Dapagliflozin combined with metformin is more effective than sitagliptin-metformin therapy in improving glycemic parameters and reducing weight over 12 weeks in T2DM patients.