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Identify Potential Subjects
History of type 2 diabetes mellitus on stable doses of either monotherapy or dual combination therapy with metformin, pioglitazone, or a sulfonylurea OR a stable dose of insulin (±20%) alone or with metformin HbA1c 6.5% (48 mmol/mol) to 8.0% (64 mmol/mol) within prior 3 months Ensure subject meets all inclusion/exclusion criteria Obtain serum HbA1c ≥ 6.5% (48 mmol/mol) and ≤ 8.0% (64 mmol/mol) Sitagliptin or Placebo
Subject will receive sitagliptin 50mg, 100mg, or placebo At Randomization
Confirm the genetics and biomarkers informed consent has been obtained Follow-up
Then visits every 6 months until study concludes After first year subjects will be contacted by phone once between each study visit Inclusion Criteria
Exclusion Criteria
1. Subject has type 2 diabetes mel itus with HbA1c of ≥ 6.5% (48 mmol/mol)
7. Subject has a history of type 1 diabetes mel itus or a history of
and ≤ 8.0% (64 mmol/mol). HbA1c must be documented within 3 months prior to study enrol ment) while receiving: 8. Subject has a history of ≥ 2 episodes of severe hypoglycemia during
• metformin, pioglitazone, or a sulfonylurea as monotherapy or any dual the 12 months prior to enrol ment. Severe hypoglycemia (hypoglycemia combination of metformin, pioglitazone, or a sulfonylurea continuously requiring assistance) refers to instances in which the subject was without alteration in dose for at least 3 months sufficiently disoriented or incapacitated as to require help from either Note: Subjects who have received insulin for only a short period (i.e.,
another individual or from medical personnel (whether or not this less than 14 days) during a hospitalization or for the management of acute il ness will not be excluded for that reason.
9. Subject has taken an approved or investigational DPP-4 inhibitor agent
(e.g., sitagliptin, alogliptin, saxagliptin, or vildagliptin), or GLP-1 analogue • a stable dose of insulin (±20% of the scheduled total daily insulin dose) (e.g., exenatide, exenatide LAR, or liraglutide), or a thiazolidinedione other either alone or in combination with a stable dose of metformin for at than pioglitazone within the past 3 months.
10. Subject has cirrhosis of the liver, as assessed by medical history.
The use of supplemental/sliding scale insulin during the prior three 11. Subject is enrol ed in another experimental protocol which involves the
months is permissible, as long as the total daily insulin dose is within use of an investigational drug or device, or an intervention that would ±20% of the scheduled total daily insulin dose.
interfere with the conduct of the trial.
Note: Subjects who have required modification of their usual insulin daily
12. Subject has a planned or anticipated revascularization procedure.
dose for a short period (i.e., less than 14 days) during a hospitalization or for the management of acute il ness will not be excluded for that reason.
13. Pregnancy or planned pregnancy during the trial period.
2. Subject is able to see a usual care provider at least twice a year.
14. Subject has medical history that indicates a life expectancy of < 2 years
or might limit the individual’s ability to take trial treatments for the duration 3. Subject is ≥ 50 years of age with preexisting vascular disease, defined as
having any one of the fol owing:• History of a major clinical manifestation of coronary artery disease 15. Subject has a history or current evidence of any condition, therapy,
(i.e., myocardial infarction, surgical or percutaneous [bal oon and/or lab abnormality, or other circumstance which, in the opinion of the stent] coronary revascularization procedure, or coronary angiography investigator or coordinator, might pose a risk to the subject, make showing at least one stenosis ≥ 50% in a major epicardial artery or participation not in the subject’s best interest, confound the results of the study (e.g., if subject cannot comply with requirements of the study), or interfere with the subject’s participation for the full duration of the study.
• Ischemic cerebrovascular disease, including: — History of ischemic stroke. Strokes not known to be hemorrhagic will 16. Subject has an estimated GFR (calculated based on serum creatinine via
the MDRD formula) of < 30 mL/min/1.73 m2.
— History of carotid arterial disease as documented by ≥ 50 % stenosis 17. Subject has a known al ergy or intolerance to sitagliptin.
documented by carotid ultrasound, magnetic resonance imaging (MRI), or angiography, with or without symptoms of neurologic deficit.
18. Subject has previously been enrol ed in this trial.
• Atherosclerotic peripheral arterial disease, as documented by objective evidence such as amputation due to vascular disease, current symptoms of intermittent claudication confirmed by an ankle-brachial pressure index or toe brachial pressure index less than 0.9 or history of surgical or percutaneous revascularization procedure.
To learn more or find out if your subject might be eligible call:
4. Female subjects agree to use an effective method of contraception or
must not otherwise be at risk of becoming pregnant.
___________________________________________________________ 5. Subject understands the study procedures, alternative treatments
available, and the risks involved with the study, and voluntarily agrees to participate by providing written informed consent.
___________________________________________________________ 6. Subject agrees to provide permission to obtain all medical records
necessary for complete data ascertainment during the fol ow-up period.



Der ökonomische Wert der biologischen Vielfalt Wirtschaftswissenschaftliche Fakultät, Universität HeidelbergGrabengasse 14, D-69117 Heidelberg, baumgaertner@uni-hd.deerscheint in: Bayerische Akademie für Naturschutz und Landschaftspflege (Hrsg.). Warumbrauchen wir einen flächendeckenden Biotopverbund? Grundlagen zum Verständnis der bio-logischen Mannigfaltigkeit, ihrer ökologischen Be


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