In a study from The GRADE Study Research Group, scientists directly compared four drugs commonly used to treat type 2 diabetes.
They found that insulin glargine and liraglutide performed the best of four medications approved by the U.S. Food and Drug Administration to maintain blood glucose levels in the recommended range.
Blood glucose management is a key component of keeping people with type 2 diabetes healthy. All four medications evaluated were added to treatment with metformin, which is the first-line drug to treat type 2 diabetes.
In the study, the team compared four major medications approved by the FDA at the time GRADE started to treat diabetes in combination with metformin.
The study enrolled 5,047 people with type 2 diabetes from diverse racial and ethnic groups who were already taking metformin. Participants were randomly placed into one of four treatment groups.
Three groups took metformin plus medicine that increased insulin levels, sitagliptin, liraglutide, or glimepiride. The fourth group took metformin and insulin glargine U-100, long-acting insulin.
After an average of 4 years of follow-up, the study found that participants taking metformin plus liraglutide or insulin glargine achieved and maintained their target blood levels for the longest time compared to sitagliptin or glimepiride.
This translated into approximately six months more time with blood glucose levels in the target range compared with sitagliptin, which was the least effective in maintaining target levels.
Treatment effects did not differ based on age, sex, race, or ethnicity.
However, none of the combinations overwhelmingly outperformed the others.
Although average blood sugar levels decreased during the study, nearly three-quarters of all participants were unable to maintain the blood glucose target over four years, underscoring the difficulty in maintaining recommended targets in many patients with type 2 diabetes.
The team says the study effectively shows which drugs worked best at achieving and maintaining blood glucose targets over time, but they need to establish even more effective strategies for the long-term maintenance of acceptable glucose levels
The study also looked at the treatments’ effects on developing diabetes-related cardiovascular disease.
Researchers found that participants in the liraglutide group were least likely to experience any cardiovascular disease overall compared to the other groups.
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The study was conducted by Dr. Henry Burch et al and published in The New England Journal of Medicine.
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