Research Sheds Light on the Most Effective Type 2 Diabetes Medications

In 2022, Dr. Neda Rasouli and a national team of researchers published groundbreaking research comparing the effectiveness of four common medications for type 2 diabetes. This study, part of the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study, was conducted to determine which medications could best help patients maintain glycemic control. Building on their initial findings, the team has now delved deeper into the data, resulting in the publication of ten new articles in Diabetes Care. Dr. Rasouli was the first author of one of these articles and a co-author on others.

The GRADE Study Overview

The GRADE study, a nationwide clinical trial, took place from 2013 to 2021 and included over 5,000 participants across 36 clinical centers in the United States, including the CU Anschutz Medical Campus. Dr. Rasouli, who is the associate division head for the Division of Endocrinology, Metabolism, and Diabetes and director of the CU Diabetes and Endocrinology Clinical Trial Program, led the CU site for the study.

Addressing the Need for Effective Diabetes Treatment

With more than 38 million people in the U.S. living with diabetes, and 90-95% of them having type 2 diabetes, finding the most effective treatments is crucial. Maintaining blood sugar levels within the near-normal range is essential for reducing the risk of complications like heart disease and kidney disease. However, type 2 diabetes is a progressive disease, and over time, maintaining glycemic control becomes increasingly difficult due to the deterioration of beta cell function, which are the cells responsible for insulin production.

The Initial Findings

Initially, the GRADE study focused on comparing four medications used in combination with metformin: insulin glargine, liraglutide, glimepiride, and sitagliptin. The results, published in the New England Journal of Medicine in 2022, indicated that liraglutide and insulin glargine were more effective at helping patients achieve and maintain their target blood glucose levels compared to glimepiride and sitagliptin.

Exploring Beta Cell Function

Following the initial publication, the research team continued to analyze the data, focusing on the long-term effects of the medications on insulin sensitivity and beta cell function. Dr. Rasouli's article highlights that while liraglutide showed significant improvement in beta cell function during the first year, this improvement did not sustain in the long term. Despite this, liraglutide still had the best beta cell function at the end of the study, followed by sitagliptin, insulin glargine, and glimepiride.

Choosing the Best Medication

Dr. Rasouli emphasizes that there is no one-size-fits-all solution for treating type 2 diabetes. The best medication depends on the individual patient's needs and circumstances. The GRADE study has shown that insulin glargine can be a safe and effective second-line therapy, often perceived as a last resort. Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, not only improves glycemic control but also promotes weight loss and has a low risk of hypoglycemia.

The Cost Factor

One major drawback of GLP-1 receptor agonists, including liraglutide, is their high cost and limited insurance coverage. Dr. Rasouli notes that if cost were not an issue, GLP-1 receptor agonists would likely be the preferred treatment for many patients.

Future Directions

The GRADE study's investigators continue to explore the vast data generated by the trial. Dr. Rasouli hopes future research will focus on interventions that can preserve beta cell function in the long term. Her aim is to develop more intensive, personalized therapies to maintain glycemic control from the early stages of diabetes, preventing complications before they arise.

Conclusion

The GRADE study underscores the importance of early, aggressive, and personalized treatment for type 2 diabetes. As Dr. Rasouli points out, addressing the disease aggressively from the beginning is key to preventing complications and ensuring long-term health for patients with diabetes.

Dominate Male Enhancement and Diabetes Niches with ALA Supplements - Health

Gluco Bliss - High-Converting VSL Supplements - Health

Referencs

https://medicalxpress.com/news/2024-07-diabetes-medication.html