Two popular drugs used to treat type 2 diabetes performed best in a large clinical trial

Two popular drugs used to treat type 2 diabetes performed best in a large clinical trial

In a large clinical trial that directly compared four drugs commonly used to treat type 2 diabetes, researchers at the University of Minnesota Medical School helped discover that insulin glargine and liraglutide performed best. The results were published in two articles in the 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 used in addition to metformin in people with short-term diabetes. Liraglutide was found to be superior to glimepiride and sitagliptin in controlling blood sugar. This study provides evidence that physicians can use when developing treatment plans with their patients.”

Elizabeth Seaquist, MD, chair of the Department of Medicine at the U of M Medical School and endocrinologist at M Health Fairview

The study found that participants who took metformin plus liraglutide or insulin glargine achieved and maintained their target blood levels the longest compared to sitagliptin or glimepiride. Compared to sitagliptin, which was the least effective at maintaining target levels, this meant blood glucose levels remained in target range for approximately six months longer. Treatment effects did not differ by age, gender, race, or ethnicity. However, none of the combinations significantly outperformed the others.

The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) study, launched in 2013, was conducted at centers across the country, including the University of Minnesota. It was designed to compare four major drugs that were approved by the Food and Drug Administration (FDA) at the time GRADE began treating diabetes in combination with metformin. While there is general agreement among health experts that metformin combined with diet and exercise is the best early approach in diabetes treatment, there is no consensus on what to do next to best control high blood sugar levels.

The GRADE study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (U01DK098246). Additional support came from the National Heart, Lung, and Blood Institute; National Institute of General Medical Sciences; National Center for the Advancement of Translation Studies; the Centers for Disease Control and Prevention; and the American Diabetes Association. The Department of Veterans Affairs provided resources and facilities. Material support in the form of donated medicines and supplies was provided by Becton, Dickinson and Company, Bristol-Myers Squibb, Merck & Co., Inc., Novo Nordisk, Roche Diagnostics and Sanofi. ClinicalTrials.gov number: NCT01794143.

Source:

University of Minnesota Medical School

Reference:

The GRADE Study Research Group., (2022) Glycemic reduction in type 2 diabetes – glycemic outcomes. New England Journal of Medicine. doi.org/10.1056/NEJMoa2200433.

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