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New study finds these two diabetes drugs perform best

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Compared to sitagliptin or glimepiride, study participants taking metformin along with liraglutide or insulin glargine were able to reach and maintain their target blood levels for the longest time.

A large-scale clinical trial found that two diabetes medications outperformed others.

Researchers at the University of Minnesota Medical School contributed to the finding that insulin glargine and liraglutide worked best in a large clinical trial that directly evaluated four drugs commonly used to treat type 2 diabetes. The findings were recently published in The New England Journal of Medicine.

“The GRADE trial is the first to compare the efficacy of four drugs commonly used to treat type 2 diabetes when added to metformin in people with short-term diabetes. It found that liraglutide was superior to glimepiride and sitagliptin in controlling blood sugars,” said Elizabeth Seaquist, MD, chair of the Department of Medicine at U of M Medical School and endocrinologist at M Health Fairview. “This study provides evidence that clinicians can use in developing treatment plans with their patient.”

Compared to sitagliptin or glimepiride, patients receiving metformin plus liraglutide or insulin glargine achieved and maintained their target blood levels for the longest period of time. Compared to sitagliptin, which was least effective at maintaining target ranges, this translated into nearly six months of additional time with blood glucose levels within target range. Age, gender, race, or ethnicity had no impact on how well a treatment worked. However, none of the combinations dramatically outperformed the others.

Launched in 2013, the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study was conducted at centers across the country, including the University of Minnesota. It was designed to compare four major medications approved by the Food and Drug Administration (FDA) at the time GRADE began treating diabetes in combination with metformin. While there is general agreement among healthcare professionals that metformin in combination with diet and exercise is the best early approach to diabetes care, there is no consensus on what to do next to best control high blood glucose. to keep.

References: “Glycemic Reduction in Type 2 Diabetes – Glycemic Outcomes” By David M. Nathan, MD, John M. Lachin, Sc.D., Ashok Balasubramanyam, MD, Henry B. Burch, MD, John B. Buse, MD, Nicole M. Butera, Ph.D., Robert M. Cohen, MD, Jill P. Crandall, MD, Steven E. Kahn, MB, Ch.B., Heidi Krause-Steinrauf, MS, Mary E. Larkin, RN, Neda Rasouli, MD, Margaret Tiktin, DNP, Deborah J. Wexler, MD, and Naji Younes, Ph.D., September 22, 2022, New England Journal of Medicine.
DOI: 10.1056/NEJMoa2200433

“Glycemic Reduction in Type 2 Diabetes – Microvascular and Cardiovascular Outcomes” by David M. Nathan, MD, John M. Lachin, Sc.D., Ionut Bebu, Ph.D., Henry B. Burch, MD, John B. Buse, MD, Andrea L. Cherrington, MD, Stephen P. Fortmann, MD, Jennifer B. Green, MD, Steven E. Kahn, MB, Ch.B., M. Sue Kirkman, MD, Heidi Krause-Steinrauf, MS, Mary E. Larkin, RN, Lawrence S. Phillips, MD, Rodica Pop-Busui, MD, Ph.D., Michael Steffes, MD, Margaret Tiktin, DNP, Mark Tripputi, Ph.D., Deborah J. Wexler, MD and Naji Younes, Ph.D., Sept. 22, 2022, New England Journal of Medicine.
DOI: 10.1056/NEJMoa2200436

The GRADE study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung and Blood Institute, the National Institute of General Medical Sciences, the National Center for Advancing Translational Sciences, the Centers for Disease Control and Prevention , and the American Diabetes Association. The Department of Veterans Affairs provided resources and facilities. Material support in the form of donated drugs and supplies has been provided by Becton, Dickinson and Company, Bristol-Myers Squibb, Merck & Co., Inc., Novo Nordisk, Roche Diagnostics, and Sanofi.

ClinicalTrials.gov Number: NCT01794143.

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