Linagliptin in type 2 diabetes mellitus: glycemic control and beyond

Abstract

Type 2 diabetes mellitus (T2DM) is a progressive metabolic disorder requiring comprehensive strategies to achieve sustained glycemic control and reduce complications. Linagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4i), provides effective glycemic control with a low risk of hypoglycaemia and weight neutrality. Its once-daily dosing without the need for renal or hepatic dose adjustment makes it suitable for patients with multiple comorbidities. Large clinical trials, including CARMELINA and CAROLINA, have established its cardiovascular and renal safety. Beyond monotherapy, combination therapy with dapagliflozin, a sodium-glucose co-transporter-2 inhibitor (SGLT2i), demonstrates synergistic benefits. This combination improves glycemic parameters, supports weight reduction, and enhances cardiorenal outcomes. Phase III trials show that fixed-dose combinations of dapagliflozin and linagliptin achieve superior HbA1c reduction and improved postprandial glucose control compared with monotherapy, with favourable safety and tolerability