Defining Disease Progression and Drug Durability in Type 2 Diabetes Mellitus

Kalra, Sanjay; Kamaruddin, Nor Azmi; Visvanathan, Jayanti; Santani, Ravi

doi:10.17925/ee.2019.15.2.67

Cited by 8 publications

(13 citation statements)

References 28 publications

(28 reference statements)

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“…Follow‐up longer than 26 weeks was recommended in DUAL VIII, 10 but 2 years was recommended in the A Diabetes Outcome Progression Trial (ADOPT) study 7 . One review in 2019 suggested 1 year, 2 but in the review written by Defronzo, more than 1.5 years was suggested for long‐term studies to evaluate durability 45 . Our review found that most patients in clinical trials reach the HbA1c nadir within 1 year; thus, the time frame to assess glycaemia should be longer than 1 year.…”

Section: Discussionmentioning

confidence: 99%

“…1 The durability of antidiabetic therapies is defined as the capacity to maintain haemoglobin A1c (HbA1c) control over an extended term and postpone the need for treatment intensification or the onset of complications. 2 Antidiabetic therapy durability is evaluated by the treatment failure rate, goal-achievement (HbA1c <7.0%) rate, treatment intensification rate and coefficient of failure (CoF, annual increase in HbA1c). However, comparing durability among different studies is difficult as neither accepted uniform evaluation criteria nor optimal time frames have been established, and many clinical trials regarding the efficacy of hypoglycaemic therapies are not sufficiently long to assess therapeutic durability.…”

Section: Introductionmentioning

confidence: 99%

“…The long‐term maintenance of glycaemic control is critical for preventing diabetic macroangiopathy and microangiopathy and reducing mortality risk in the management of patients with diabetes 1 . The durability of antidiabetic therapies is defined as the capacity to maintain haemoglobin A1c (HbA1c) control over an extended term and postpone the need for treatment intensification or the onset of complications 2 . Antidiabetic therapy durability is evaluated by the treatment failure rate, goal‐achievement (HbA1c <7.0%) rate, treatment intensification rate and coefficient of failure (CoF, annual increase in HbA1c).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Durability of glycaemic control in type 2 diabetes: A systematic review and meta‐analysis for its association with body weight changes

Zou

Yin

et al. 2020

Diabetes Obesity Metabolism

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Aims To analyse quantitatively the association between the durability of glycaemic control and body weight changes during treatment. Materials and methods This study adhered to an appropriate methodology according to Meta‐analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Studies with follow‐ups >12 months, and final and intermediate assessments of haemoglobin A1c (HbA1c) and body weight were included. Four outcomes assessing therapeutic durability were extracted and synthesized using Stata statistical software, including changes in HbA1c, goal‐achievement rate, failure rate and coefficient of failure (CoF). Results After 8.9 months of treatment, HbA1c levels declined from 8.03% [95% confidence interval (CI), 7.91‐8.15; I2 = 99.2%] to 7.15% (95% CI, 7.02‐7.27; I2 = 99.4%) and then gradually increased up to 7.72% (95% CI, 7.50‐7.94; I2 = 99.0%) 5 years later. The goal‐achievement rate decreased from 54.8% (after 1 year of treatment) to 19.4% 5 years later. The CoF was 0.123 ± 0.022%/year (P < .001). After stratification, the CoFs were 0.224 ± 0.025%/year (P < .001) for weight gain, 0.137 ± 0.034%/year (P < .001) for neutral weight and −0.024 ± 0.032%/year (P = .450) for weight loss. After stratification by treatment approaches, the CoFs were 0.45%/year for insulin, 0.43%/year for sulphonylurea, 0.34%/year for thiazolidinediones, 0.29%/year for metformin, 0.16% for glucagon‐like polypeptide‐1 receptor agonists, 0.12% for surgery, −0.03% for sodium‐glucose cotransporter‐2 inhibitors and −0.21% for dipeptidyl peptidase‐IV inhibitors. Conclusion Modest weight loss with a goal of 2‐3% of body weight should be recommended to improve therapeutic durability and prevent beta‐cell deterioration.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Durability of glycaemic control in type 2 diabetes: A systematic review and meta‐analysis for its association with body weight changes

Zou

Yin

et al. 2020

Diabetes Obesity Metabolism

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“…Disease progression may be observed as a rise in HbA1c while on the same drug regimen, requiring intensification of therapy in order to regain glycaemic control [28]. Patients were assumed to receive either empagliflozin or oral semaglutide, in addition to metformin, until Hba1c of 7.5% (58 mmol/mol) was exceeded; this is the threshold for treatment intensification, defined in the NICE guidelines [19].…”

Section: Treatment Intensification and Long-term Disease Progressionmentioning

confidence: 99%

Long-Term Cost-Effectiveness Analyses of Empagliflozin Versus Oral Semaglutide, in Addition to Metformin, for the Treatment of Type 2 Diabetes in the UK

Ramos¹,

Cummings

Ustyugova

et al. 2020

Diabetes Ther

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“…Recent study found that new therapeutic drugs containing sodium glucose co-transporter 2(SGLT2) inhibitors, dipeptidyl peptidase-4 inhibitors and glucagon-like polypeptide-1(GLP-1) analogue had better glycemic control when monotherapy or combination with other drugs are taken for T2DM. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of dapagliflozin plus saxagliptin vs monotherapy as added to metformin in patients with type 2 diabetes

Zhuang¹,

Song²,

Ying

et al. 2020

Medicine

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Defining Disease Progression and Drug Durability in Type 2 Diabetes Mellitus

Cited by 8 publications

References 28 publications

Durability of glycaemic control in type 2 diabetes: A systematic review and meta‐analysis for its association with body weight changes

Durability of glycaemic control in type 2 diabetes: A systematic review and meta‐analysis for its association with body weight changes

Long-Term Cost-Effectiveness Analyses of Empagliflozin Versus Oral Semaglutide, in Addition to Metformin, for the Treatment of Type 2 Diabetes in the UK

Efficacy and safety of dapagliflozin plus saxagliptin vs monotherapy as added to metformin in patients with type 2 diabetes

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