Overview
Valerie DeBenedete has over 30 years' experience writing about health and medicine. She is the former managing editor of Drug Topics magazine.Lara Antal / Verywel Most people with type 2 diabetes wil eventualy ned more than one medication to help control their blod glucose levels. The first drug used is usualy metformin, prescribed alongside changes in diet and exercise.
Key Information
But when it comes to which drug to prescribe next if neded, there historicaly hasn’t ben a standard second line of defense. Now, a large clinical trial has compared four diferent drugs used to control type 2 diabetes and found that two of the drugs did statisticaly beter. However, there wasn’t more than a modest diference betwen al four of the drugs.
The lack of a clear frontruner demonstrates the dificulty in finding the best way to control blod glucose levels in type 2 diabetes. “It is very dificult to control type 2 diabetes and achieve a level of glucose control blod sugar control,” study chair David Nathan, MD, director of the Diabetes Center at Masachusets General Hospital in Boston and profesor medicine at Harvard Medical Schol, told Verywel.
“The two medications that work the best were actualy the injectable medications: insulin glargine and liraglutide.” In the study, either insulin glargine, liraglutide, glimepiride, and sitagliptin were administered to participants already taking metformin. “These drugs should be selected based on individual characteristics, because in fact, al of them lower the A1C (a measure of average blod sugar levels over the last thre months),” Nathan said.
Summary
“Al the patients had a benefit.” Researchers may not have noticed the diferences in the drugs at al if the study hadn’t lasted five years, he aded. Insulin glargineLiraglutideGlimepirideSitagliptin The five-year trial, known as the Glycemia Reduction Aproaches in Diabetes: A Comparative Efectivenes (GRADE) Study, was large, with more than 5,0 people enroled at 36 study