What is the clinical evidence from this study?

Study design: Cohort. Population: Type 2 diabetes mellitus and hypertension (n=52). Intervention: Sitagliptin and metoprolol combination therapy vs. Sitagliptin alone. Primary outcome: Fasting plasma glucose (mmol/L) at 12 weeks (p=<0.001).

What question did this study set out to answer?

To evaluate the clinical safety and therapeutic efficacy of combining sitagliptin with metoprolol in elderly patients with type 2 diabetes mellitus and hypertension.

October 8, 2026Open MedicineOpen Access

Safety study of sitagliptin combined with metoprolol on the treatment of elderly patients with type 2 diabetes mellitus and hypertension

Q: What are the key findings of this study?

In elderly patients with type 2 diabetes and hypertension, the combination of sitagliptin and metoprolol significantly reduced fasting plasma glucose, HbA1c, and blood pressure over 12 weeks compared to sitagliptin alone, without a significant increase in adverse events.

Q: What question did this study set out to answer?

To evaluate the clinical safety and therapeutic efficacy of combining sitagliptin with metoprolol in elderly patients with type 2 diabetes mellitus and hypertension.

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Key result

Adding metoprolol to sitagliptin linked to ~1.5 mmol/L greater fasting glucose reduction vs. sitagliptin alone.

P<0.001
n=52

Why the study?

The safety of combining sitagliptin and metoprolol in elderly patients with type 2 diabetes mellitus and hypertension was not well established.

Does sitagliptin combined with metoprolol improve blood glucose, blood pressure, inflammation, coagulation, and liver-kidney function in elderly patients with T2DM and hypertension?

Key Points

To evaluate the clinical safety and therapeutic efficacy of combining sitagliptin with metoprolol in elderly patients with type 2 diabetes mellitus and hypertension.
Retrospectively collected medical records of 52 elderly patients with type 2 diabetes mellitus and hypertension treated between June 2021 and March 2024.
Categorized patients into two 12-week treatment arms: sitagliptin combined with metoprolol (n=26) versus sitagliptin monotherapy (n=26) at a single center.
The combination therapy group achieved significantly greater reductions in systolic blood pressure and diastolic blood pressure compared to monotherapy (p<0.05).
The combination arm demonstrated superior improvements across inflammation, coagulation, and liver-kidney indices, including lower CRP, NLR, Fib, Scr, and BUN, as well as higher PT and APTT (p<0.05).
No statistically significant difference in the incidence of adverse events occurred between the two treatment groups (p>0.05).

Study Design

Type

Cohort (n=52)

Multicenter

Structured PICO

Does sitagliptin combined with metoprolol improve blood glucose, blood pressure, inflammation, coagulation, and liver-kidney function in elderly patients with T2DM and hypertension?

Population

52 elderly patients with type 2 diabetes mellitus and hypertension were retrospectively analyzed over a 12-week period to compare sitagliptin plus metoprolol versus sitagliptin alone.

Exposure

Sitagliptin (100 mg/day oral tablet) combined with metoprolol (47.5 mg/day oral tablet) for 12 weeks.

Comparator

Sitagliptin monotherapy (100 mg/day oral tablet) for 12 weeks. Patients in this group had mild hypertension but did not take antihypertensive drugs as prescribed.

Outcome

Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), and diastolic blood pressure (DBP) after 12 weeks of treatment.surrogate

Main Result

Absolute Event Rate: 6.14% vs 7.67%

p-value: p=<0.001

Limitations

Unbalanced control design because the control group did not receive balanced antihypertensive interventions.
Small sample size of 52 patients.
Short follow-up period of 12 weeks lacking long-term cardiovascular and safety data.
Did not uniformly and systematically monitor fasting and postprandial hypoglycemia episodes or dynamic resting heart rate changes.
Included only elderly patients, limiting the generalizability to middle-aged and younger adults.
Deficiencies in retrospective data collection meant baseline confounding indicators such as cardiovascular history could not be adjusted.
No correction for multiple comparisons in secondary indicator analyses.
Non-randomized controlled design precluded blinded assessment, leading to selection bias.
Unbalanced antihypertensive interventions between the two groups (control group lacked antihypertensive therapy).
Short 12-week follow-up period lacking long-term efficacy and safety data.
Small sample size precluding comprehensive risk assessment for adverse events like bradycardia.
Lack of systematic monitoring for hypoglycemia episodes and resting heart rate.
Retrospective non-randomized design with unrecorded baseline confounders (cardiovascular history, concomitant medications) precluding baseline adjustment and blinded assessment.
Restricted to elderly patients, limiting generalizability.

Implication

May support combination use in elderly T2DM with hypertension; hypothesis-generating and requires prospective RCTs before practice change.

Abstract

Objectives: Sitagliptin is a standard therapeutic option for type 2 diabetes mellitus (T2DM), while metoprolol is an antihypertensive agent. This study aimed to assess the safety of their combination therapy in elderly patients with T2DM and hypertension. Methods: Medical data of 52 elderly patients with T2DM and hypertension from June 2021 to March 2024 were retrospectively collected. According to different treatment methods, 52 patients were categorized into the sitagliptin + metoprolol group (n=26) and the sitagliptin group (n=26). After a 12-week treatment period, the baseline characteristics, therapeutic efficacy and biochemical indicators were analyzed between groups. Results: , SBP, and DBP levels (p<0.05). The combination group also achieved greater improvements in immune-inflammation, coagulation, and liver-kidney function (lower CRP, NLR, Fib, Scr and BUN, as well as higher PT and APTT) (p<0.05). There was no significant difference in incidence of adverse event between the two groups (p>0.05). Conclusions: Short-term observation indicates that sitagliptin combined with metoprolol can improve blood glucose, blood pressure, inflammation, coagulation, and liver-kidney function in elderly patients with T2DM and hypertension, without a significant increase in the risk of adverse reactions during short-term follow-up. However, as a single-center, small-sample retrospective study, the present findings should be interpreted as preliminary clinical evidence.

Discussion

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Cite This Study

Dai et al. (2026) conducted a cohort in Type 2 diabetes mellitus and hypertension (n=52). Sitagliptin and metoprolol combination therapy vs. Sitagliptin alone was evaluated on Fasting plasma glucose (mmol/L) at 12 weeks (p=<0.001). In elderly patients with type 2 diabetes and hypertension, the combination of sitagliptin and metoprolol significantly reduced fasting plasma glucose, HbA1c, and blood pressure over 12 weeks compared to sitagliptin alone, without a significant increase in adverse events.

synapsesocial.com/papers/6ac6e3c182aa59ee98b3fef7 https://doi.org/10.1515/med-2026-1538

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Implication

May support combination use in elderly T2DM with hypertension; hypothesis-generating and requires prospective RCTs before practice change.

Safety study of sitagliptin combined with metoprolol on the treatment of elderly patients with type 2 diabetes mellitus and hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Safety study of sitagliptin combined with metoprolol on the treatment of elderly patients with type 2 diabetes mellitus and hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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