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Although incretin-based therapy effectively treats type 2 diabetes mellitus, emerging reports of acute pancreatitis in patients receiving sitagliptin and exenatide have prompted the US Food and Drug Administration to issue an alert on these drugs.

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The indirect comparisons using the outcome proportions of HbA1c responders (achieving HbA1c less than 7 %) similarly demonstrated no statistically significant differences in responder rates between vildagliptin and sitagliptin or rosiglitazone.

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The main drivers of growth will be the dramatic increase in disease prevalence and physicians' efforts to delay disease progression and reduce the costly burden of diabetic complications through the use of combination therapies and novel branded drugs.

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Galvus Met is indicated as add-on to insulin as an adjunct to diet and exercise to improve glycaemic control in patients when stable dose of insulin and metformin alone do not provide adequate glycaemic control.

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It must be emphasized that diabetes and hypertriglyceridemia are itself independent risk factors for development of pancreatitis and an analysis of a US healthcare database showed that rates of pancreatitis with exenatide or sitagliptin were no different from metformin or glyburide.

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