**4. Lipid profile**

**3. Carbohydrate metabolism**

60 Diabetes and Its Complications

(**Figure 3**).

\*P < 0.05; \*\* P > 0.05.

After 24 weeks, a significant decrease in all parameters of carbohydrate metabolism was observed in group I. Level of FPG in group I decreased by 2.67 ± 2.37 mmol/L (21%), р <0.001, FPG decrease in group II has not reached statistical significance with the mean decrease of 0.33 ± 1.6 mmol/L (1.45%), р > 0.05. Postprandial glucose (PPG) decreased by 3.26 ± 2.54 mmol/L (26.35%), р <0.001 in group I and by 0.64 ± 1.2 mmol/L (5.31%), p < 0.05 in group II. HbA1c level decreased by 1.63 ± 1.31% (18.52%), р <0.001 in group I, and by 0.72 ± 0.47% (8.17%) in group II

**Figure 2.** Dynamics of anthropometric parameters. P < 0.001 for all values; P between groups <0.001 for all value.

The largest success in achieving glycemic control in patients on combined treatment is associated with complimentary action of the therapy components. Metformin lowers insulin resistance and hepatic glucose production, while Sitagliptin delays inactivation of GLP-1, thus enhancing glucose-dependent insulin secretion and decreasing glucagon secretion [17]. In addition, it was demonstrated that metformin leads to increase in overall GLP-1 and can

**Figure 3.** Dynamics of carbohydrate metabolism in the groups. GF-glucose fasting, PPG-postprandial glycemia;

Lipid profile parameters belong to the improvement indices of the metabolic health.

The analysis of the lipid profile showed significant positive dynamics of TC, HDL and Apo B in both groups. The only difference between groups was in HDL and TG dynamics. HDL level decreased by 0.78 ± 0.5 mmol/L (17.43%), p < 0.001 in group I, and by 0.37 ± 0.17 mmol/L (9.63%), р <0.001 in group II; TG decreased by 1.33 ± 1.16 mmol/L (28.15%), p < 0.001 in group I, and by 0.63 ± 0.39 mmol/L (15.19%), р <0.001 in group II. **Figure 4** displays parameter dynamics in both groups.

Possible mechanisms partaking in the positive effect on lipid profile from therapy by DPP-4 inhibitor in combination with metformin could be weight loss, lowering of glucose level, decrease in visceral fat (VF), which is accompanied by improvement in metabolic status.

**Figure 4.** Dynamics of lipid profile. \*\*\* P < 0.001; \*\*P < 0.05; \*P > 0. 05 between groups.
