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Longitudinal changes in HbA1c following treatment intensification after inadequate response to two oral antidiabetic agents in patients with type 2 diabetes

Diabetes, Obesity and Metabolism Mar 15, 2019

Kim K, et al. - Using a regional health plan claims database from January 1, 2010, to March 31, 2017, researchers conducted a retrospective cohort study to determine change in HbA1c (A1c) for 1 year after treatment intensification in patients with A1c > 7.0% while on two classes of oral antidiabetic agents (2OADs). For this investigation, they included patients with type 2 diabetes (T2DM) whose treatment was intensified with insulin, a GLP-1 receptor agonist, or a third OAD within 365 days of an A1c ≥ 7.0% on 2OADs. Using a mixed-effects regression model, A1c trajectory for 1 year after intensification was estimated. Findings revealed that intensification following A1c ≥ 7.0% on 2OADs was linked to a significant improvement in glycemic control in T2DM patients. Insulin-intensified patients had a higher A1c baseline but greater A1c reduction than non-insulin-intensified patients. However, overall, A1c remained above 8.0%.

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