{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:39:50Z","timestamp":1787755190406,"version":"build-2784847793"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Clin. Diabetes Healthc."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Real-world evidence on dipeptidyl peptidase-4 (DPP-4) inhibitors is limited by selective populations in randomized trials. The international, prospective DIVERSITY study evaluated the effectiveness, safety, and treatment acceptability of sitagliptin and sitagliptin\/metformin single-pill combination (SPC) in routine clinical practice across diverse type 2 diabetes (T2D) populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This non-interventional, multicenter study enrolled adults with T2D eligible for sitagliptin or sitagliptin\/metformin SPC and followed them for 6 months with three data captures (baseline, ~3 months, ~6 months). The analysis set comprised 2,603 patients (mean age 64.6y \u00b1 10.6; 53.1% women) meeting all criteria and with \u2265152 days between first and third captures. Primary outcomes were absolute changes in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and post-prandial glucose (PPG) from baseline to 6 months. Secondary outcomes included the proportion achieving HbA1c &amp;lt;7% at 3 and 6 months, changes in body mass index (BMI), and hypoglycemia incidence. Safety was assessed in all treated patients (safety analysis set [SAS], n=2,697).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Glycemic control improved over the 6-month observation period. Among patients with paired data, mean HbA1c fell from 7.98% to 6.99% (\u0394 \u22120.99%, 95% CI \u22121.05 to \u22120.93). Reductions were observed with both regimens: sitagliptin monotherapy (\u0394 \u22120.93%, 95% CI \u22121.01 to \u22120.85) and sitagliptin\/metformin SPC (\u0394 \u22121.03%, 95% CI \u22121.11 to \u22120.96). FPG decreased by \u22121.91 mmol\/L (95% CI \u22122.03 to \u22121.79) and PPG by \u22122.39 mmol\/L (95% CI \u22122.56 to \u22122.21). The share of patients with HbA1c &amp;lt;7% rose from 16.9% at baseline to 53.7% at 6 months. BMI changes were small and consistent with weight neutrality (mean \u22120.61 \u00b1 1.33 kg\/m\u00b2). Treatment-related symptoms of hypoglycemia were rare (3 cases [0.1%] of all treated patients) and treatment acceptability was high: \u226590% patients and investigators reported satisfaction at 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In routine practice across heterogeneous T2D populations, sitagliptin and sitagliptin\/metformin SPC were associated with clinically meaningful improvements in HbA1c, FPG, and PPG over 6 months, with effects consistent with a weight-neutral profile, a low reported incidence of hypoglycemia, and high treatment satisfaction. These findings are consistent with the use of sitagliptin-based regimens, whether used as monotherapy or as add-on therapy, as treatment options in routine real-world care, including in older and multimorbid patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcdhc.2026.1905393","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:38:49Z","timestamp":1787751529000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world outcomes of sitagliptin and sitagliptin\/metformin single-pill combination treatment in diverse type 2 diabetes populations (DIVERSITY study)"],"prefix":"10.3389","volume":"7","author":[{"given":"Andrej","family":"Janez","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjana","family":"Bojic","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Clinical Center of the Republic of Srpska","place":["Banja Luka, Bosnia and Herzegovina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomislav","family":"Bozek","sequence":"additional","affiliation":[{"name":"Vuk Vrhovac University Clinic, Clinical Hospital Merkur, Zagreb, Croatia University of Zagreb School of Medicine","place":["Zagreb, Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zdravko","family":"Kamenov","sequence":"additional","affiliation":[{"name":"Clinic of Endocrinology, Alexandrovska University Hospital","place":["Sofia, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Milenkovic","sequence":"additional","affiliation":[{"name":"University Clinic of Endocrinology, Diabetes and Metabolic Diseases","place":["Skopje, North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Radulian","sequence":"additional","affiliation":[{"name":"National Institute of Diabetes, Nutrition and Metabolic Diseases N. 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