In a nutshell
This study investigated the blood sugar reduction and sid-effects associated with 4 different drug combinations in type 2 diabetes.
Some background
Metformin (Glucophage) decreases glucose production. It is often the first choice of treatment for type 2 diabetes. Commonly, other drugs are prescribed to be taken alongside it, including albiglutide (Tanzeum), sitagliptin (Januvia) and glimepiride (Amaryl). The aim of combining these drugs with metformin is to control diabetes by reducing HbA1c levels. HbA1c is a measurement of blood glucose (sugar) levels over the past 3 months. Unfortunately, these treatments can produce unwanted side effects, for example skin reactions at the site at which the drug was injected (injection-site reactions).
Methods & findings
The authors aimed to compare different drug combinations in type 2 diabetes with reference to their effectiveness and their side-effects.
302 participants were treated with metformin and albiglutide. 302 were treated with metformin and sitagliptin. 307 were treated with metformin and glimepiride. 101 participants were treated with metformin and a placebo (a substance with no therapeutic effect, used as a comparison). The HbA1c levels of patients were measured at the start of the study and 104 weeks later. Side effects were monitored.
HbA1c levels were reduced by 0.63% in those taking albiglutide , 0.28% in those taking sitagliptin and 0.36% in those taking glimepiride. HbA1c levels rose by an average of 0.27% in those who received a placebo.
Most side effects reported were at similar levels for the 4 participant groups. However a higher percentage of people in the albiglutide group (17.5%) experienced injection-site reactions than any of the other groups (7.8% or less for all groups).
The bottom line
This study concluded that a combination of metformin and albiglutide reduces HbA1c levels more effectively other drug combinations, without a significant increase in adverse side effects.
The fine print
Drug dosage was not consistent for all participants. Depending on blood glucose levels, dosage of some drugs was increased for some participants.
What’s next?
If you are currently taking metformin and pioglitazone, and are worried about the implications of heart failure risk raised here, please talk to your doctor
Published By :
Diabetes Care
Date :
Jun 04, 2014
