Choosing the best sequence of medications for patients with T2D not optimally controlled on metformin is a challenge with the expansion of the diabetic toolbox. Results from the GRADE study can help inform clinicians' choices. MedTwitter
Because studies of this type require a long lead-in, TZDs were not included due to safety concerns. SGLT2 inhibitors posed a design challenge, having been introduced to the marketplace after the protocol was set, yet established as a helpful, if not essential medicine for people with some renal or cardiac conditions. They could not be withheld, but their use was left to the discretion of each patient's physician.
In addition to monitoring glycemia, participants were assessed for markers of cardiac and renal risks, including blood pressure and lipid therapy. Some was left to the discretion of treating physicians. Many who were not already on an antihypertensive or statin on entry into the study had this added as the quarterly assessments proceeded, suggesting that overall care became more meticulous as a consequence of enrollment.
On following these people for 5 years, the need to intensify treatment occurred in the vast majority, ranging from 67% with insulin to 77% with sitagliptin. Among the sitagliptin cohort, treatment failure occurred within the first year 55% of the time, compared with about 40% with the other medications. Both injectables outperformed both oral agents, though neither injectable outperformed the other.
On the reassuring side, the non-White and Native American participants, whose diabetic outcomes often underperform, seemed to do as well as everyone else when provided medication and consistent professional reassessment. This information is likely to enable better diabetic care, even if the medicines themselves leave something to be desired.
United States Latest News, United States Headlines
Similar News:You can also read news stories similar to this one that we have collected from other news sources.
As Ukraine assesses damage in Kherson, Russia bans ship traffic in key waterwayTwo days after Russian forces pulled out of Kherson, Ukrainian authorities warned some enemy soldiers could still be holed up in the now-liberated southern city.
Read more »
NASA assesses Artemis moon rocket after brush with Hurricane NicoleNASA's $4.1 billion Artemis moon rocket, exposed to the elements atop its Kennedy Space Center launch pad, was rocked by high winds and driving rain early Thursday as Hurricane Nicole roared ashore just south of the spaceport.
Read more »
In a 1st, child treated for rare, often-fatal disorder while still in the wombA child with Pompe disease was the first to start treatments before birth.
Read more »
Everett ER patients join study for new meth treatment drug that offers hope for combating addictionSome members of the medical community say Everett is one of the larger hot spots for meth addiction in the nation. Doctors say it's an everyday problem in the emergency room in Everett, with patients coming in who are suffering from meth addition and a host of associated impacts.
Read more »
New Study Reveals How the Reproductive System Can Accelerate Aging and Worsen HealthThe study identified the negative consequences of disrupting meiosis. A new study in an animal model of aging indicates a potential reason for why women who have early menopause or other genetic conditions affecting the reproductive system are more prone to develop cardiovascular disease, diabetes,
Read more »
Universal masking leads to fewer covid cases in schools, study findsNew data backs public health rules from earlier in the pandemic.
Read more »