Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes

@article{Maruthur2016DiabetesMA,
  title={Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes},
  author={Nisa M Maruthur and Eva Tseng and Susan M. Hutfless and Lisa M Wilson and Catalina Suarez‐Cuervo and Zackary D Berger and Yue Chu and Emmanuel Iyoha and Jodi B Segal and Shari D. Bolen},
  journal={Annals of Internal Medicine},
  year={2016},
  volume={164},
  pages={740-751}
}
Type 2 diabetes and its complications are a substantial public health burden, affecting 9.3% of the U.S. adult population (1, 2). Most patients with type 2 diabetes eventually require glucose-lowering pharmacologic therapy, with a goal of reducing long-term complications. More than 7 classes of diabetes medications, which differ in their effects on glucose-lowering, safety, and other important outcomes, are recommended as first- or second-line therapy (3, 4). The Agency for Healthcare Research… 
National trends in metformin-based combination therapy of oral hypoglycaemic agents for type 2 diabetes mellitus
TLDR
The results show that the prescription pattern was influenced by the type and location of the institution, specialty of physicians, some comorbidities, and patient characteristics such as age and sex, and newer agents were more commonly used in younger patients.
SGLT2 inhibitor/DPP-4 inhibitor combination therapy – complementary mechanisms of action for management of type 2 diabetes mellitus
  • J. Dey
  • Medicine
    Postgraduate medicine
  • 2017
TLDR
The rationale for combination therapy with sodium glucose cotransporter-2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors, and evidence from clinical trials with empagliflozin and linagliptin or dapaglif lozin and saxagli leptin in the management of type 2 diabetes mellitus are reviewed.
Oral and Injectable (Non-insulin) Pharmacological Agents for Type 2 Diabetes
TLDR
This chapter provides an overview and description of the existing oral and injectable (non-insulin) pharmacological agents for type 2 diabetes along with an up-to-date listing of those.
Combination SGLT2 inhibitor and GLP-1 receptor agonist therapy: a complementary approach to the treatment of type 2 diabetes
TLDR
Patients with type 2 diabetes who received exenatide plus dapagliflozin added to their treatment regimen for 28 weeks had significantly greater reductions from baseline in glycated hemoglobin, body weight, and systolic blood pressure compared with patients who received either drug as monotherapy.
Use of non-insulin diabetes medicines after insulin initiation: A retrospective cohort study
TLDR
While metformin was commonly continued among commercially insured adults starting insulin, rates of continuation of other non-insulin diabetes medications were also high.
Where Does Metformin Stand in Modern Day Management of Type 2 Diabetes?
TLDR
This review article will revisit the major cardiovascular outcome data for metformin and include a critique of the UKPDS data, review additional factors that might be pertinent to meetformin’s status as a first-line agent, and answer key questions when considering met formin‘s role in the modern-day management of T2D.
"Genetic Contribution and Inhibitor Marker of Diabetic Disease: A Review Article"
TLDR
Therapy with oral medication with inhibitors is for patients not receiving an intensive insulin regimen and HbA1C levels should be assessed regularly in all diabetic patients, according to current guidelines.
Should sodium-glucose cotransporter-2 inhibitors be first-line treatment for patients with type 2 diabetes?
TLDR
This research highlights the importance of good glucose control in the treatment of type 2 diabetes by finding that intensive control by any treatment significantly decreased risks of diabetes-related outcomes, myocardial infarction and all-cause mortality.
Drugs for Treatment of Diabetes Mellitus
  • R. Seifert
  • Medicine
    Basic Knowledge of Pharmacology
  • 2019
TLDR
Type 2 DM therapy is alleviation of insulin resistance with calorie restriction and an active lifestyle, and Metformin is the best studied and most effective drug for treatment of type 2 DM.
...
...

References

SHOWING 1-10 OF 97 REFERENCES
Systematic Review: Comparative Effectiveness and Safety of Oral Medications for Type 2 Diabetes Mellitus
TLDR
A systematic review was commissioned to summarize the comparative benefits and harms of oral agents that are used to treat type 2 diabetes and selected studies that reported on major clinical outcomes or any of the following intermediate end points or adverse events.
Comparative Effectiveness and Safety of Medications for Type 2 Diabetes: An Update Including New Drugs and 2-Drug Combinations
TLDR
Evidence supports metformin as a first-line agent to treat type 2 diabetes and most 2-drug combinations similarly reduce hemoglobin A(1c) levels, but some increased risk for hypoglycemia and other adverse events.
Mortality among veterans with type 2 diabetes initiating metformin, sulfonylurea or rosiglitazone monotherapy
TLDR
Significantly higher mortality was associated with glibenclamide, glipizide and rosiglitazone use compared with metformin, and with glipzide useCompared with rosigsig litazone or glibanclamide and with women using metformIn monotherapy compared with men, with women having a higher HR.
United Kingdom Prospective Diabetes Study 24: A 6-Year, Randomized, Controlled Trial Comparing Sulfonylurea, Insulin, and Metformin Therapy in Patients with Newly Diagnosed Type 2 Diabetes That Could Not Be Controlled with Diet Therapy
TLDR
The response to treatment with oral hypoglycemic drugs or insulin in a subgroup of patients recruited to the UKPS who continued to have marked hyperglycemia or hyperglycemic symptoms during the initial 3 months of diet therapy and in whom continued diet therapy alone was not an option is reported.
10-year follow-up of intensive glucose control in type 2 diabetes.
TLDR
Despite an early loss of glycemic differences, a continued reduction in microvascular risk and emergent risk reductions for myocardial infarction and death from any cause were observed during 10 years of post-trial follow-up.
Comparative Effectiveness of Sulfonylurea and Metformin Monotherapy on Cardiovascular Events in Type 2 Diabetes Mellitus
TLDR
Use of sulfonylureas compared with metformin for initial treatment of diabetes was associated with an increased hazard of CVD events or death.
Effects of intensive glucose lowering in type 2 diabetes.
TLDR
The use of intensive therapy to target normal glycated hemoglobin levels for 3.5 years increased mortality and did not significantly reduce major cardiovascular events and identify a previously unrecognized harm of intensive glucose lowering in high-risk patients with type 2 diabetes.
Dapagliflozin add-on to metformin in type 2 diabetes inadequately controlled with metformin: a randomized, double-blind, placebo-controlled 102-week trial
TLDR
Dapagliflozin added to meetformin for 102 weeks enabled sustained reductions in HbA1c, FPG, and weight without increased risk of hypoglycemia in patients with type 2 diabetes who were inadequately controlled on metformin alone.
...
...