***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: ETHNOPHARMACOLOGICAL RELEVANCE Scutellaria-coptis herb couple ( SC ) is the main herb couple in many traditional Chinese compound formulas used for the treatment of diabetes mellitus , which has been used to treat diabetes mellitus for thous and s of years in China . In this study we provide experimental evidence for the clinical use of SC in the treatment of diabetes mellitus . AIM OF THE STUDY To confirm the anti-diabetic effect of SC extract and its main components , and to explore its mechanism from the effect on intestinal disaccharidases by in vivo and in vitro experiment . MATERIAL S AND METHODS SC extract was prepared and the main components ( namely berberine and baicalin ) contained in the extract were assayed with high performance liquid chromatography ( HPLC ) . And diabetic model rats were induced by intraperitoneal injection of streptozotocin ( STZ ) .  After grouped r and omly , diabetic rats were administered SC extract , berberine , baicalin , berberine+baicalin , acarbose and vehicle for 33d , respectively . Body weight , food intake , urine volume , urine sugars , fasting plasma glucose and fasting plasma insulin were monitored to evaluate the antidiabetic effects on diabetic rats . Intestinal mucosa homogenate was prepared and the activities of intestinal disaccharidases were assayed . Moreover , oral sucrose tolerance test ( OSTT ) was performed and the inhibitory effects of SC extract and its main components ( berberine and baicalin ) on the maltase and sucrase in vitro was evaluated . RESULTS After the treatment of SC extract and its main components , the body weight and the fasting plasma insulin level were found to be increased while food intake , urine volume , urine sugars and fasting plasma were decreased . OSTT showed that SC extract and its main components could lower the postpr and ial plasma glucose level of diabetic rats . Furthermore , SC extract and its main components could inhibit the activities of intestinal disaccharidases in diabetic rats , whereas only SC extract and berberine could inhibit the activity of maltase in vitro . CONCLUSIONS According to our present findings , scutellaria-coptis herb couple ( SC ) possessed potent anti-hyperglycemic effect on STZ-induced diabetic rats . And SC extract and its main components exerted anti-hyperglycemic effect partly via inhibiting the increased activities of intestinal disaccharidases and elevating the level of plasma insulin in diabetic rats induced by STZ Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background The high prevalence and incidence of type 2 diabetes mellitus ( DM ) , and its associated morbidity and mortality , has prompted growing international interest and effort in the primary prevention of this disease . Primary prevention is possible since type 2 DM is preceded by prediabetes , offering a window opportunity to treat patients , and prevent the emergence of advanced disease . Sitagliptin is an oral dipeptidyl peptidase-IV inhibitor that preserves existing beta cell function and increases beta cell mass . These two effects have been demonstrated both in vitro and in animal studies , and current clinical data show that sitagliptin is safe . Metformin , a biguanide , reduces insulin resistance and inhibits hepatic gluconeogenesis , and has an excellent safety profile . The combination of metformin and sitagliptin , targeting both characteristics of prediabetes ( insulin resistance and progressive beta cell degeneration ) , may potentially slow or halt the progression from prediabetes to type 2 DM . This paper describes the rationale and design of the Sitagliptin and Metformin in PreDiabetes ( SiMePreD ) study . Objective The aim of this study is to determine the effect of sitagliptin and metformin on progression from prediabetes to type 2 DM . The objectives of the study are to determine the effects of metformin and placebo on glycemic endpoints , the effects of sitagliptin and metformin on glycemic endpoints , the effects of metformin and placebo on incidence of cardiovascular disease and death , and the effects of sitagliptin and metformin on incidence of cardiovascular disease and death . Methods This is a r and omized , double-blind , multicenter clinical study that will determine if the combination of metformin and sitagliptin is effective in preventing the progression from prediabetes to type 2 DM . The study will contain two arms ( metformin/sitagliptin and metformin/placebo ) . Primary endpoints include the number of subjects progressing from prediabetes to type 2 DM , the number of cardiovascular events , and the number of deaths . The planned duration of the study is five years , and 410 subjects will be included in each group . Data analyses will include clinical ly relevant measures ( eg , numbers needed to treat and numbers needed to harm ) and will be performed according to the intention-to-treat principle . Results This study is currently in the process of acquiring research funding . Conclusions The SiMePreD study is the first study to investigate the utility of sitagliptin in combination with metformin for the primary prevention of type 2 DM AIM To assess efficacy/safety of initial linagliptin/metformin single-pill combination ( SPC ) therapies versus individual drug components over 24weeks in treatment-naïve Asian patients with type 2 diabetes mellitus and insufficient glycemic control . METHODS Patients ( initial glycated hemoglobin [ HbA1c ] ⩾7.5 % to < 11.0 % [ 58 - 97mmol/mol ] ; main group ) were r and omized to : linagliptin 5 mg once daily ( qd ) ; metformin 500 mg twice daily ( bid ) ; metformin 1000 mg bid ; linagliptin 2.5mg/metformin 500 mg bid ; or linagliptin 2.5mg/metformin 1000 mg bid . Patients with severe hyperglycemia ( HbA1c ⩾11.0 % [ 97mmol/mol ] )  received linagliptin 2.5mg/metformin 1000 mg bid or linagliptin 5 mg qd ( switched at week 12 from linagliptin to SPC if HbA1c > 8.0 % [ 64mmol/mol ] ) . The main group primary endpoint was HbA1c change from baseline to week 24 . RESULTS At week 24 , adjusted mean change from baseline in HbA1c ( main group , n=733 ) was : linagliptin 5 mg qd , -1.3 % ; metformin 500 mg bid , -1.6 % ; metformin 1000 mg bid , -2.1 % ; linagliptin 2.5mg/metformin 500 mg bid , -2.2 % ; linagliptin 2.5mg/metformin 1000 mg bid , -2.3 % . The first test of primary HbA1c analysis ( linagliptin 2.5mg/metformin 1000 mg bid vs. metformin 1000 mg bid ) was borderline non-significant ; however , SPCs produced significantly greater reductions in HbA1c from baseline versus respective monotherapies in all but one pre-defined sensitivity analysis . In the severe hyperglycemia group ( n=143 ) , linagliptin 2.5mg/metformin 1000 mg bid produced a superior HbA1c reduction ( -4.7 % ) versus linagliptin 5 mg qd ( -3.5 % ) after 12weeks . Hypoglycemic adverse events were low across groups . CONCLUSIONS Initial linagliptin/metformin SPC significantly improved glycemic control in this population 
    Output:
    
The GQD and metformin had a synergistic effect on glycemic control in comparison to metformin alone as a T2DM therapy .