Comparative Effectiveness of Metformin Dosage Uptitration Versus Adding Another Antihyperglycemic Medication on Glycemic Control in Type 2 Diabetes Patients Failing Initial Metformin Monotherapy: A Retrospective Cohort Study
| Autor: | Holly Mulder, Tsai-Ling Liu, Rohan Mahabaleshwarkar |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male endocrine system medicine.medical_specialty endocrine system diseases Leadership and Management Administration Oral Blood sugar Type 2 diabetes Cohort Studies Pharmacotherapy Internal medicine medicine Electronic Health Records Humans Hypoglycemic Agents Adverse effect Aged Proportional Hazards Models Retrospective Studies Glycemic business.industry Health Policy digestive oral and skin physiology Public Health Environmental and Occupational Health nutritional and metabolic diseases Retrospective cohort study Middle Aged medicine.disease Metformin Diabetes Mellitus Type 2 Glycemic Index Female business human activities medicine.drug Cohort study |
| Zdroj: | Population Health Management. 22:457-463 |
| ISSN: | 1942-7905 1942-7891 |
| Popis: | Metformin is recommended as first-line treatment for type 2 diabetes (T2D). A disadvantage of metformin is the possibility of gastrointestinal adverse effects in some patients. Many T2D patients are not able to achieve/maintain glycemic control from initial metformin treatment and receive treatment intensification by means of metformin dosage uptitration or addition of a T2D drug. This retrospective study evaluated the comparative effectiveness of these 2 treatment intensification strategies. The study cohort included T2D patients at a US integrated health care system who: were initiated on metformin monotherapy (MM) during January 2009 - September 2013; had an uncontrolled HbA1c (≥7%) after at least 90 days of MM; and received metformin dosage uptitration or an additional T2D medication within 6 months of the uncontrolled HbA1c reading. Statistical techniques included Kaplan-Meier curves and Cox proportional hazards regression. The study cohort included 1167 patients, 52.4% male and 65.1% white, with a mean age of 55.3 (±11.9) years. Of these, 49.1% received metformin dosage uptitration and 50.9% received an additional T2D medication. Metformin dosage uptitration was as effective as adding another T2D medication with the probability of not achieving glycemic control ( |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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