Impact of Insulin Sensitivity and β-Cell Function Over Time on Glycemic Outcomes in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE): Differential Treatment Effects of Dual Therapy
Diabetes Care, ISSN: 1935-5548, Vol: 47, Issue: 4, Page: 571-579
2024
- 3Citations
- 6Usage
- 21Captures
- 1Mentions
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Metrics Details
- Citations3
- Citation Indexes3
- CrossRef1
- Usage6
- Abstract Views6
- Captures21
- Readers21
- 21
- Mentions1
- News Mentions1
- 1
Most Recent News
New Findings from University of Washington Update Understanding of Antidiabetic Agents [Impact of Insulin Sensitivity and B-cell Function Over Time On Glycemic Outcomes In the Glycemia Reduction Approaches In Diabetes: a Comparative ...]
2024 DEC 03 (NewsRx) -- By a News Reporter-Staff News Editor at NewsRx Diabetes Daily -- Fresh data on Drugs and Therapies - Antidiabetic Agents
Article Description
OBJECTIVE To compare the effects of insulin sensitivity and β-cell function over time on HbA and durability of glycemic control in response to dual therapy. RESEARCH DESIGN AND METHODS GRADE participants were randomized to glimepiride (n = 1,254), liraglutide (n = 1,262), or sitagliptin (n = 1,268) added to baseline metformin and followed for mean ± SD 5.0 ± 1.3 years, with HbA assessed quarterly and oral glucose tolerance tests at baseline, 1, 3, and 5 years. We related time-varying insulin sensitivity (HOMA 2 of insulin sensitivity [HOMA2-%S]) and early (0–30 min) and total (0–120 min) C-peptide (CP) responses to changes in HbA and glycemic failure (primary outcome HbA ≥7% [53 mmol/mol] and secondary outcome HbA >7.5% [58 mmol/mol]) and examined differential treatment responses. RESULTS Higher HOMA2-%S was associated with greater initial HbA lowering (3 months) but not subsequent HbA rise. Greater CP responses were associated with a greater initial treatment response and slower subsequent HbA rise. Higher HOMA2-%S and CP responses were each associated with lower risk of primary and secondary outcomes. These associations differed by treatment. In the sitagliptin group, HOMA2-%S and CP responses had greater impact on initial HbA reduction (test of heterogeneity, P = 0.009 HOMA2-%S, P = 0.018 early CP, P = 0.001 total CP) and risk of primary outcome (P = 0.005 HOMA2-%S, P = 0.11 early CP, P = 0.025 total CP) but lesser impact on HbA rise (P = 0.175 HOMA2-%S, P = 0.006 early CP, P < 0.001 total CP) in comparisons with the glimepiride and liraglutide groups. There were no differential treatment effects on secondary outcome. CONCLUSIONS Insulin sensitivity and β-cell function affected treatment outcomes irrespective of drug assignment, with greater impact in the sitagliptin group on initial (short-term) HbA response in comparison with the glimepiride and liraglutide groups.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85188967722&origin=inward; http://dx.doi.org/10.2337/dc23-1059; http://www.ncbi.nlm.nih.gov/pubmed/38190619; https://diabetesjournals.org/care/article/47/4/571/154056/Impact-of-Insulin-Sensitivity-and-Cell-Function; https://hsrc.himmelfarb.gwu.edu/gwhpubs/4842; https://hsrc.himmelfarb.gwu.edu/cgi/viewcontent.cgi?article=5841&context=gwhpubs; https://hsrc.himmelfarb.gwu.edu/gwhpubs/4200; https://hsrc.himmelfarb.gwu.edu/cgi/viewcontent.cgi?article=5199&context=gwhpubs; https://dx.doi.org/10.2337/dc23-1059; https://diabetesjournals.org/care/article/doi/10.2337/dc23-1059/154056/Impact-of-Insulin-Sensitivity-and-Cell-Function
American Diabetes Association
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