Choice of the Add-on Therapy to Metformin in Type 2 Diabetes Patients in Clinical Practice. Initial Results from a Non-Interventional Multicenter Study in Romania (REALITY)

Abstract

Metformin, a biguanide, remains the most widely used first-line type 2 diabetes drug. It is generally considered weight-neutral with chronic use and does not increase the risk of hypoglycaemia. Most patients eventually require more than one antihyperglycemic agent to achieve target blood glucose levels. The primary objective of this non-interventional study was to describe and compare the main criteria used by physicians from regular outpatient setting in selecting the add-on therapy in patients with inadequately metformincontrolled type 2 diabetes in 2 time points at 1-year distance by assessment of patient, and/or agent characteristics and/or physician decision. At the end of phase one of the study, the mean duration of type 2 diabetes was 6.8 years. The majority of patients included in the study were overweight (32%) and obese (62%), and presented diabetes complications (59.6%). In 50% of the cases, the major reason for selecting the second-line therapy was related to patient characteristics, while agent characteristics and physician decision were the main categories in 38% and 12%, respectively. Importance to achieve glycemic control and estimated treatment efficacy were selected in 73.9% and 82.4% of patients, calculated as percentage in the respective categories.

Patients Treated with Insulin and Sulphonylurea are at Increased Mortality Risk as Compared with Insulin Plus Metformin

“…While this issue dates back from The University Group Diabetes Program, where tolbutamide was associated with a significant increase in all-cause and cardiovascular mortality, the more robustly conducted UK Prospective Diabetes Study showed no increased mortality in relation to sulphonylurea exposure (13,14). Many other treatment options for type 2 diabetes are now available, and all have their up-and downsides (15,16).…”

Choice of the Add-On Therapy to Metformin in Type 2 Diabetes Patients in Romania

“…The study by C. Serafinceanu et al (1), dealing with the reasons guiding physicians to select additional medication in type 2 diabetes mellitus when treatment with metformin only does not lead to sufficient metabolic control of the disease (HbA1c), has aroused our outmost interest.…”