5. Conclusions
HYPOGLYCEMIA, TYPE 2 DIABETES
In this RCT of drug-naïve Korean patients with type 2 diabetes, 77% of the patients treated with the gemigliptin–metformin combination therapy achieved the glycemic target goal of HbA1c ≤ 7.0% (53 mmol/mol) without hypoglycemia. This approach favorably altered the gut microbiota and amino acid levels, suggesting potential improvements in pancreatic β-cell function and anti-inflammatory effects. Our findings suggest that changes in the gut microbiota are important for augmenting the efficacy of gemigliptin therapy. This may apply to DPP-4 inhibitors in more general terms.