the myCME.com take:
Initiating diabetes treatment with metformin reduces the need for subsequent treatment, according to new research published in the Journal of the American Medical Association Internal Medicine. However, the study found more than 40% of patients with diabetes do not start out with metformin despite recommended guidelines. Here’s what you need to know:
- The findings of this study indicate that starting therapy with metformin in patients who do not have any contraindications to the agent is the optimal strategy for beginning oral hypoglycemic therapy.
- Patients who received a different treatment other than metformin first had a higher risk for adding a second oral agent only, insulin only, and a second agent or insulin (P<.001 for all). Of participants, 24.5% who received initial metformin required a second agent compared to those who initially received sulfonylurea (37.1%), a thiazolidinedione (39.6%), or a DPP-IV inhibitor (36.2%).
- These results strongly back guidelines from the American Diabetes Association, American College of Physicians, and others who recommend metformin as the first-line therapy for diabetes.