If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Early Initiation of Metformin Extends the Agent’s Duration of Efficacy in Patients With Type 2 Diabetes PORTLAND, Ore -- March 10, 2010 -- The sooner patients with type 2 diabetes start taking metformin, the longer the drug remains effective, according to a Kaiser Permanente study published in the March issue of Diabetes Care, a journal of the American Diabetes Association. The study found that metformin worked nearly twice as long for people who began taking it within 3 months of their diabetes diagnosis. This is the first study to compare metformin failure rates in a real-world, clinical practice setting. Other studies compared failure rates of metformin only in clinical trials. Metformin is recommended as a first-line agent in the treatment of type 2 diabetes, but in most patients it eventually stops working, forcing them to take additional medications to control their blood glucose levels. Each additional drug adds extra costs and the possibility of more side effects including weight gain, researchers said. “This is an important finding for the 30 million people world-wide who are diagnosed with type 2 diabetes every year. The sooner they start taking metformin, the better and longer it seems to work,” said the study’s lead author Jonathan B. Brown, PhD, Kaiser Permanente Center for Health Research, Portland, Oregon. ‘This study suggests that to gain full benefit from metformin, patients should start taking it as soon as they find out they have diabetes.” Researchers used electronic health records to follow nearly 1,800 people with diabetes in Kaiser Permanente’s health plan in Washington and Oregon for up to 5 years. Metformin failed at a rate of only 12% a year for the patients who began taking it within 3 months of diagnosis. That compares to a failure rate of 21.4% per year for patients who started taking metformin 1 to 2 years after diagnosis, and 21.9% per year for those who didn’t start taking the drug until 3 years after they were diagnosed. “We believe that starting the drug early preserves the body’s own ability to control blood sugar, which in turn prevents the long-term complications of diabetes, like heart disease, kidney failure, and blindness,” said study co-author Gregory A. Nichols, PhD, Kaiser Permanente Center for Health Research. “The American Diabetes Association recommends that patients start taking metformin and make lifestyle changes as soon as they are diagnosed. This study provides more evidence to back up that recommendation.” In the study, patients were considered to have failed metformin when their haemoglobin A1C went above 7.5% or when they started taking a second anti-hyperglycaemic agent. Only patients who initially controlled blood glucose levels, defined as <7% on the A1C test, with metformin were included in the study. To reduce the possibility that factors other than delay in starting metformin influenced the results of the study, researchers controlled for age, gender, and how well blood glucose was controlled prior to treatment. After controlling for these factors, an even stronger relationship emerged between the time a patient started on the drug, and the amount of time it remained effective. Still, the authors caution that other unmeasured factors could have influenced the results.
SOURCE: Kaiser Permanente Center for Health Research
|
