Metformin Beats Other T2DM Meds for Initial Treatment

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Metformin Beats Other T2DM Meds for Initial Treatment
Metformin Beats Other T2DM Meds for Initial Treatment

(HealthDay News) -- Patients newly diagnosed with type 2 diabetes who are initially prescribed metformin are less likely to eventually need other medications to control their blood glucose, according to research published online Oct. 27 in JAMA Internal Medicine.

Niteesh Choudhry, M.D., of the Harvard Medical School in Boston, and colleagues collected data on 15,516 people starting treatment for type 2 diabetes from July 2009 through June 2013. The average follow-up time was slightly longer than one year. Of those patients, 57.8 percent were initially treated with metformin, and about one-quarter began treatment with a sulfonylurea. Just 6 percent were started with a thiazolidinedione, and 13 percent with a dipeptidyl peptidase 4 inhibitor (DPP-4) inhibitor.

The researchers found that around 40 percent of people taking a sulfonylurea, a thiazolidinedione, or a DPP-4 inhibitor added a second drug to their diabetes treatment regimen during the study. Just 25 percent of those on metformin added an additional oral medication during the study period. In addition, 5 percent of those started on metformin later added insulin to their treatment, according to the study. About 9 percent of those who started on a sulfonylurea, 6 percent of those who started on a DPP-4 inhibitor, and 6 percent of those who started on thiazolidinediones, also took insulin.

Choudhry said that many patients are being started on other drugs, but this study indicates that treatment should start with metformin. "This study supports the predominant practice, which is that most people are started on metformin," Choudhry told HealthDay. "Metformin, which is one of the oldest drugs we have and which the guidelines recommend as being the first drug to use, is associated with a lower risk of needing to add a second drug or insulin compared to any of three other commonly used classes of drugs."

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