New Study Finds That These Two Diabetes Drugs Perform the Best

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Compared with sitagliptin or glimepiride, study participants who were taking metformin 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 drugs 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 results were published recently New England Journal of Medicine.

“The GRADE study is the first to compare the effectiveness 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 sugar,” said Elizabeth Squist, MD, chair of medicine at the U of M Medical School and an endocrinologist at M Health Fairview. “This study provides evidence that clinicians can use in developing treatment plans with their patients.”

Compared with sitagliptin or glimepiride, patients receiving metformin plus liraglutide or insulin glargine reached and maintained their target blood levels for the longest time. Compared with sitagliptin, which was the least effective at maintaining target levels, this translated into approximately six months of additional time with blood glucose levels in the target range. Age, sex, race, or ethnicity had no effect on how well a treatment worked. None of the combinations dramatically outperformed the others.

Launched in 2013, Glycemia Reduction 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 drugs approved by the Food and Drug Administration (FDA) when GRADE began treating diabetes in combination with metformin. Although there is general agreement among health care professionals that metformin combined with diet and exercise is the best initial approach in diabetes care, there is no consensus on what should be done next to control high blood glucose.

References: “Lowering Glycemia in Type 2 Diabetes — Glycemic Outcomes” by Nicole M. Butera, Ph.D., Robert M. Cohen, MD, Jill P. Crandall, MD, Steven E. Kahn, MB, CHB, Heidi Krause-Steinroff, MS, Mary E. Larkin, RN, Neda Rasouli, MD, Margaret Tiktin, DNP, Deborah J. Wexler, MD and Naji Younes, Ph.D., 22 Sep 2022, New England Journal of Medicine.
DOI: 10.1056/NEJMoa2200433

“Lowering glycemia in type 2 diabetes — microvascular and cardiovascular outcomes” David M. Nathan, MD, John M. Lachin, ScD, Aynat Bebu, PhD, Henry B. Birch, MD, John B. Boos, 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 Pope-Busui, MD, PhD, Michael Steffes, MD, Margaret Ticktin, DNP, Mark Triputi, PhD, Deborah J. Wexler, MD and Naji Yunus, PhD, 22 Sep 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 Science, the Centers for Disease Control and Prevention, and the American Diabetes Association. The Department of Veterans Affairs provided resources and benefits. Material support in the form of donated drugs and supplies was provided by Becton, Dickinson and Company, Bristol-Myers Squibb, Merck & Co., Inc., Novo Nordisk, Roche Diagnostics, and Sanofi. number: NCT01794143.


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