Why carry out this study?

Metformin has been prescribed at lower doses in patients with type 2 diabetes (T2D) in Japan than those in Western countries despite evidence on its dose-dependent hypoglycemic effects

We compared the effect of increasing the metformin dose on glycemic control in patients previously receiving low doses of metformin to that of a combination therapy with dipeptidyl peptidase-4 inhibitors (DPP-4i) and that of a replacement therapy with DPP-4i by using a Japanese clinical database

What was learned from the study?

The effect of increasing the metformin dose on glycemic control was similar to that of a combination therapy with DPP-4i and that of a replacement therapy with DPP-4i

Increasing metformin dosage could be one of the next treatment options in patients who were prescribed low-dose metformin as the first-line treatment