Abstract
Treatment of type 2 diabetes mellitus should be, according to the recommendations of European Association for the Study of Diabetes and American Diabetes Association, initiated by metformin monotherapy with stepwise addition of other medications, if HbA1c level exceeds 53 mmol/mol. The use of combination therapy as an initiation of antidiabetic treatment has not been routinely recommended owing to lack of quality studies showing superiority of this approach as compared to initiation by metformin monotherapy with stepwise intensification.
The first completed study that has clearly demonstrated the advantages of initial combination therapy as compared to metformin monotherapy was VERIFY trial that showed the positive impact of initial combination treatment for vildagliptin/metformin combination. In this paper, we describe the possibilities of initial combination therapy in patients with type 2 diabetes focusing on the results of VERIFY trial and discuss its possible impact on the current clinical practice and future perspective of antidiabetic treatment.