Scientists from thirty-six U.S. study centres have found that insulin ‘glargine’ and ‘liraglutide’ performed best out of four medications to maintain blood glucose levels in the recommended range.
In a large clinical trial designed to compare four major medications approved by the Food and Drug Administration (FDA), the researchers evaluated all four medications, and added them to treatment with metformin, which is the first-line drug to treat Type II diabetes.
While there is general agreement among healthcare professionals that metformin combined with diet and exercise is the best early approach in diabetes care, there is no consensus on what to do next to best keep high blood glucose in check.
Dr. Henry Burch, NIDDK’s project scientist for GRADE said: “This study was designed to provide healthcare providers with important information on how to guide the long-term management of Type II diabetes.
“This is an integral step toward precision medicine for diabetes care, as these results can now be used in the decision-making process for each individual patient in light of their levels of glucose control, how well the medications are tolerated, and the person’s other health considerations.”
The study enrolled 5,047 people with Type II diabetes from diverse racial and ethnic groups who were already taking metformin. Participants were randomly placed into one of four treatment groups. Three groups took metformin plus a medicine that increased insulin levels, sitagliptin, liraglutide, or glimepiride. The fourth group took metformin and insulin glargine U-100, long-acting insulin.
The results of the study found that participants taking metformin plus liraglutide or insulin glargine achieved and maintained their target blood levels for the longest time compared to sitagliptin or glimepiride. This translated into approximately six months time with blood glucose levels in the target range compared with sitagliptin, which was the least effective in maintaining target levels.
Treatment effects did not differ based on age, sex, race, or ethnicity.
Trial was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health.