[HTML][HTML] The durability of oral diabetic medications: time to A1c baseline and a review of common oral medications used by the primary care provider
L Cherukuri, MS Smith, JA Tayek - Endocrinology, diabetes and …, 2018 - ncbi.nlm.nih.gov
L Cherukuri, MS Smith, JA Tayek
Endocrinology, diabetes and metabolism journal, 2018•ncbi.nlm.nih.govMethods: Papers in PubMed were identified with keywords placebo. The study must be at
least 2 years in length to evaluate the change in A1c over time. The primary endpoint was
time to A1c neutrality (return of A1c to baseline at a maximum dose of single oral agent). A
medication would be considered at neutrality if the 95% CI crossed baseline. Time to
neutrality was averaged for each medication within the class and each summarized for class
effect. Results: Effective therapy for the DPP-4 and sulfonylurea classes of medications are 3 …
least 2 years in length to evaluate the change in A1c over time. The primary endpoint was
time to A1c neutrality (return of A1c to baseline at a maximum dose of single oral agent). A
medication would be considered at neutrality if the 95% CI crossed baseline. Time to
neutrality was averaged for each medication within the class and each summarized for class
effect. Results: Effective therapy for the DPP-4 and sulfonylurea classes of medications are 3 …
Methods:
Papers in PubMed were identified with keywords placebo. The study must be at least 2 years in length to evaluate the change in A1c over time. The primary endpoint was time to A1c neutrality (return of A1c to baseline at a maximum dose of single oral agent). A medication would be considered at neutrality if the 95% CI crossed baseline. Time to neutrality was averaged for each medication within the class and each summarized for class effect.
Results:
Effective therapy for the DPP-4 and sulfonylurea classes of medications are 3–4 years as compared to a 5-year time to A1c neutrality for metformin usage. In comparison, the projected time to A1c neutrality was approximately 6–8 years for rosiglitazone and pioglitazone. While only a few studies have been published in the SGLT-2 class of medication, the time to A1c neutrality was also 6–8 years with Canagliflozin and full dosage of Empagliflozin.
Conclusion:
Metformin appears to have a 5-year duration of effect before the A1c returns to baseline. The sulfonylureas and DPP-4 inhibitors class of medications have one of the shortest durability which ranges between 3.3 to 4.4 years. In contrast, the SGLT-2 class of medication and the TZD class of medications has a projected time to A1c neutrality from 6–8 years. Diabetic duration of therapy as compared to placebo should be listed with those medications tested so the provider can choose wisely.
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