Benefit of Early Intensification of Therapy After Metformin Failure

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Early intensification of treatment after metformin failure in type 2 diabetes may speed achievement of HbA1c goals.
Early intensification of treatment after metformin failure in type 2 diabetes may speed achievement of HbA1c goals.

(HealthDay News) — For patients newly diagnosed with type 2 diabetes, early intensification of therapy after metformin failure is associated with more rapid attainment of HbA1c goals, according to a study published in Diabetes Care.

Kevin M. Pantalone, DO, from the Cleveland Clinic, and colleagues identified patients with newly diagnosed type 2 diabetes who failed to reach the HbA1c goal after 3 months of metformin monotherapy. The authors compared the time to HbA1c goal attainment in patients who received early intensification of therapy (within 6 months of metformin failure) or late intensification. The analysis was performed in 1 168 679, and 429 patients for HbA1c goals of 7%, 7.5%, and 8%, respectively.

The researchers found that when poor glycemic control was defined as HbA1c greater than 7.0%, greater than 7.5%, and greater than 8.0%, treatment was intensified early in 62%, 69%, and 72% of patients, respectively. The higher the HbA1c category, the greater the probability was of undergoing an early intensification. 

Among patients who received early intensification, time to HbA1c goal attainment was shorter, regardless of the HbA1c goal (all P<.05).

"A substantial number of patients with newly diagnosed type 2 diabetes fail to undergo intensification of therapy within 6 months of metformin monotherapy failure," the researchers wrote. "Early intervention in patients when metformin monotherapy failed resulted in more rapid attainment of HbA1c goals."

Disclosures: Several authors disclosed financial ties to biopharmaceutical companies, including Merck, which funded the study.

Reference

  1. Pantalone KM, Wells BJ, Chagin KM, et al. Intensification of Diabetes Therapy and Time Until A1C Goal Attainment Among Patients With Newly Diagnosed Type 2 Diabetes Who Fail Metformin Monotherapy Within a Large Integrated Health System. Diabetes Care. 2016. doi:10.2337/dc16-0227.
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