A Landmark Study: What Is the Best Second Drug in Type 2 Diabetes?
Hello. I am Elizabeth Seaquist from the University of Minnesota, and I am here in Barcelona at the European Association for the Study of Diabetes (EASD) meeting. It has been a very exciting meeting and we have heard much about the treatment of type 2 diabetes. There are so many unanswered questions, however, that I wanted to talk about a study that we are doing in the United States that should help us with some of these questions.
The basic question that we need to answer is: What is the best second drug to give to people with type 2 diabetes after metformin? Which second drug used in combination with metformin can keep blood sugars well controlled as long, and what can do so the longest?
This study is called GRADE and it is being conducted at 37 centers across the United States. One reason to talk with you about this study is that physicians across the country can help us with this study. We are looking for people with type 2 diabetes who have had the disease for less than 5 years, who are being treated with either diet or metformin alone, and who are interested in participating in a landmark study. We are going to ask them to come into our study, make sure they tolerate their metformin, get their A1c levels to target, and then randomly assign them to 1 of 4 drugs. These are drugs that we currently use every day in clinical practice but we really don't know which drug is the best. The agents that we will use are:
• A sulfonylurea (glimepiride);
• A DPP-4 inhibitor (sitagliptin)
• A GLP-1 agonist (liraglutide); and
• A basal insulin (glargine insulin).
Send Us Your Patients!
We hope to determine in patients with new-onset type 2 diabetes, if they were started on metformin, which of these 4 drugs is best used with metformin to keep that person at target A1c level for the longest.
The real benefits of having your patients participate is that they receive free medications for the duration of the study. That makes a huge difference in my clinical practice. We will also give them test strips. We will do their diabetes testing and share all of those results with you, their primary healthcare provider or endocrinologist, and then we will watch them over time. We will see them quarterly and assess their blood glucose levels over time. We want to see all of these patients. If you want to contact us or refer patients, we have a Website set up where you can pick the center closest to you. So, send us your patients and have an impact on this question. It is going to be a landmark study that will help us decide how to best treat people with new-onset type 2 diabetes. What drug combination works best? We really don't know the answer to that question at this time.
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Cite this: Send Us Your Type 2 Patients! - Medscape - Oct 11, 2013.