Secondary Failure of Metformin Monotherapy in Clinical Practice
| Autor: | Gregory A. Nichols, C Conner, Jonathan B. Brown |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Research design medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism Drug Resistance Drug resistance Logistic regression Cohort Studies Internal medicine Diabetes mellitus Internal Medicine medicine Humans Hypoglycemic Agents Treatment Failure Aged Original Research Glycemic Advanced and Specialized Nursing business.industry Clinical Care/Education/Nutrition/Psychosocial Research nutritional and metabolic diseases Professional Practice Middle Aged medicine.disease Metformin Surgery Clinical Practice Drug Combinations Diabetes Mellitus Type 2 Female business Follow-Up Studies Cohort study medicine.drug |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc09-1749 |
| Popis: | OBJECTIVE We sought to document the secondary failure rate of metformin monotherapy in a clinical practice setting and to explore factors that predict therapeutic failure. RESEARCH DESIGN AND METHODS We studied 1,799 type 2 diabetic patients who, between 2004 and 2006, lowered their A1C to RESULTS Of the 1,799 patients studied, 42% (n = 748) experienced secondary failure; the mean failure rate was 17% per year. However, patients who initiated metformin within 3 months of diabetes diagnosis failed at an age-and A1C-adjusted rate of 12.2% (10.5–14.4%) per year, and patients who initiated while A1C was CONCLUSIONS Although metformin failure may occur more rapidly in clinical practice than in clinical trails, initiating it soon after diabetes diagnosis and while A1C is low might preserve β-cell function, prolong the effectiveness of metformin, reduce lifetime glycemic burden, and prevent diabetes complications. Our findings support the current treatment algorithm for hyperglycemia management that recommends metformin initiation when diabetes is first diagnosed. |
| Databáze: | OpenAIRE |
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