A recent study by researchers at the University of North Carolina has identified two medications, liraglutide and insulin glargine, as the most effective options for controlling blood sugar levels in people with type 2 diabetes when used alongside metformin.
The findings provide valuable guidance for doctors and patients managing this common chronic condition.
Type 2 diabetes occurs when the body doesn’t use insulin properly, leading to high blood sugar levels. Metformin is often the first medication prescribed to control blood sugar. However, when metformin alone is no longer enough, additional medications are typically needed.
In this study, researchers compared the effectiveness of four medications commonly used with metformin: two oral drugs (glimepiride and sitagliptin) and two injectable drugs (insulin glargine and liraglutide).
The study involved 5,000 participants with type 2 diabetes, with about 1,250 patients assigned to each medication. Participants’ average blood sugar levels were measured using A1C, a standard test that reflects blood sugar control over the past few months.
The results showed that liraglutide and insulin glargine were the most effective at keeping A1C levels below 7%, the target range for many people with diabetes.
Glimepiride had a smaller effect, while sitagliptin was the least effective. Insulin glargine was particularly strong at keeping A1C levels below 7.5%, another important benchmark.
The study also highlighted that these differences were more pronounced in patients who had higher A1C levels at the start, indicating that liraglutide and insulin may be especially beneficial for individuals struggling with poor blood sugar control on metformin alone.
In addition to blood sugar control, the medications had varying effects on weight. Participants treated with liraglutide and sitagliptin experienced more weight loss, while those on glimepiride or insulin glargine maintained stable weight.
Liraglutide, however, was associated with more gastrointestinal side effects, including nausea, abdominal pain, and diarrhea.
Glimepiride was linked to a higher risk of severe low blood sugar (hypoglycemia), although these events were rare.
On the other hand, preliminary findings suggested that liraglutide might provide additional heart and vascular benefits, including reduced risks of heart attacks and strokes, compared to the other medications.
These findings offer clear guidance for choosing a second medication when metformin alone is insufficient. Injected liraglutide and basal insulin glargine are likely to provide better long-term blood sugar control, particularly for patients with poorly controlled diabetes.
However, side effects and individual patient needs, such as weight management or heart health, should also factor into the decision.
The study, led by Dr. Sue Kirkman, helps clarify the benefits and drawbacks of these medications, empowering both patients and doctors to make informed choices in managing type 2 diabetes.
If you care about diabetes, please read studies about high vitamin D level linked to lower dementia risk in type 2 diabetes, and this eating habit could help reduce risk of type 2 diabetes.
For more information about nutrition, please see recent studies about unhealthy plant-based diets linked to metabolic syndrome, and results showing Mediterranean diet could help reduce the diabetes risk by 30%.
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