ArticleBMC endocrine disorders2016
Diabetes treatment intensification and associated changes in HbA1c and body mass index: a cohort study.
Article in BMC endocrine disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- A greater proportion of participants with type 2 diabetes achieve treatment targets with insulin degludec/liraglutide versus insulin glargine 100 units/mL at 26 weeks: DUAL VIII, a randomized trial designed to resemble clinical practice.Diabetes, obesity & metabolism · 2020Trial
- Article
- Reported organic food consumption and metabolic syndrome in older adults: cross-sectional and longitudinal analyses.European journal of nutrition · 2022Article
- Dose distribution and up-titration patterns of metformin monotherapy in patients with type 2 diabetes.Endocrinology, diabetes & metabolism · 2020Article
- Evaluation of weight change and hypoglycaemia as mediators in the association between insulin use and death.Diabetes, obesity & metabolism · 2019Article
- In vitro differentiation of human multilineage differentiating stress-enduring (Muse) cells into insulin producing cells.Journal, genetic engineering & biotechnology · 2018Article
- Comparative Safety of Sulfonylurea and Metformin Monotherapy on the Risk of Heart Failure: A Cohort Study.Journal of the American Heart Association · 2017Article
- Second-Line Agents for the Treatment of Type 2 Diabetes and Prevention of CKD.Clinical journal of the American Society of Nephrology : CJASN · 2016Article
- The neurobiology of the Prader-Willi phenotype of fragile X syndrome.Intractable & rare diseases research · 2016Review
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6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundTo describe common type 2 diabetes treatment intensification regimens, patients' characteristics and changes in glycated hemoglobin (HbA1c) and body mass index (BMI).
methodsWe constructed a national retrospective cohort of veterans initially treated for diabetes with either metformin or sulfonylurea from 2001 through 2008, using Veterans Health Administration (VHA) and Medicare data. Patients were followed through September, 2011 to identify common diabetes treatment intensification regimens. We evaluated changes in HbA1c and BMI post-intensification for metformin-based regimens.
resultsWe identified 323,857 veterans who initiated diabetes treatment. Of these, 55 % initiated metformin, 43 % sulfonylurea and 2 % other regimens. Fifty percent (N = 89,057) of metformin initiators remained on metformin monotherapy over a median follow-up 58 months (interquartile range [IQR] 35, 74). Among 80,725 patients who intensified metformin monotherapy, the four most common regimens were addition of sulfonylurea (79 %), thiazolidinedione [TZD] (6 %), or insulin (8 %), and switch to insulin monotherapy (2 %). Across these regimens, median HbA1c values declined from a range of 7.0-7.8 % (53-62 mmol/mol) at intensification to 6.6-7.0 % (49-53 mmol/mol) at 1 year, and remained stable up to 3 years afterwards. Median BMI ranged between 30.5 and 32 kg/m(2) at intensification and increased very modestly in those who intensified with oral regimens, but 1-2 kg/m(2) over 3 years among those who intensified with insulin-based regimens.
conclusionsBy 1 year post-intensification of metformin monotherapy, HbA1c declined in all four common intensification regimens, and remained close to 7 % in subsequent follow-up. BMI increased substantially for those on insulin-based regimens.
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