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For patients newly diagnosed with type 2 diabetes, early intensification of therapy after metformin failure is associated with more rapid attainment of hemoglobin A1c (A1C) goals, according to a study published online Aug. 12 in Diabetes Care.

Kevin M. Pantalone, D.O., from the Cleveland Clinic, and colleagues identified patients with newly diagnosed type 2 diabetes who failed to reach the A1C goal after three months of metformin monotherapy. The authors compared the time to A1C goal attainment in patients who received early intensification of therapy (within six months of metformin failure) or late intensification. The analysis was performed in 1,168, 679, and 429 patients for A1C goals of 7, 7.5, and 8 percent, respectively.

The researchers found that when poor glycemic control was defined as A1C >7.0, >7.5, and >8.0 percent, treatment was intensified early in 62, 69, and 72 percent of patients, respectively. The higher the A1C category, the greater the probability was of undergoing an early intensification. Among patients who received early intensification, time to A1C goal attainment was shorter, regardless of the A1C goal (all P < 0.05).

“A substantial number of patients with newly diagnosed type 2 diabetes fail to undergo intensification of therapy within six months of metformin monotherapy failure,” the authors write. “Early intervention in patients when metformin monotherapy failed resulted in more rapid attainment of A1C goals.”

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

Full article:

For patients newly diagnosed with type 2 diabetes, early intensification of therapy after metformin failure is associated with more rapid attainment of hemoglobin A1c (A1C) goals, according to a study published online Aug. 12 in Diabetes Care.

Kevin M. Pantalone, D.O., from the Cleveland Clinic, and colleagues identified patients with newly diagnosed type 2 diabetes who failed to reach the A1C goal after three months of metformin monotherapy. The authors compared the time to A1C goal attainment in patients who received early intensification of therapy (within six months of metformin failure) or late intensification. The analysis was performed in 1,168, 679, and 429 patients for A1C goals of 7, 7.5, and 8 percent, respectively.

The researchers found that when poor glycemic control was defined as A1C >7.0, >7.5, and >8.0 percent, treatment was intensified early in 62, 69, and 72 percent of patients, respectively. The higher the A1C category, the greater the probability was of undergoing an early intensification. Among patients who received early intensification, time to A1C goal attainment was shorter, regardless of the A1C goal (all P < 0.05).

“A substantial number of patients with newly diagnosed type 2 diabetes fail to undergo intensification of therapy within six months of metformin monotherapy failure,” the authors write. “Early intervention in patients when metformin monotherapy failed resulted in more rapid attainment of A1C goals.”

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

Full article: http://care.diabetesjournals.org/content/early/2016/07/06/dc16-0227

Author

PV Mayer

Dr. Perry Mayer is the Medical Director of The Mayer Institute (TMI), a center of excellence in the treatment of the diabetic foot. He received his undergraduate degree from Queen’s University, Kingston and medical degree from the Royal College of Surgeons in Ireland.

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