Progression of glucose-lowering diabetes therapy in TECOS

Endocrinology, Diabetes & Metabolism
M Angelyn BethelTECOS Study Group

Abstract

TECOS was a randomized, double-blind, placebo-controlled trial assessing the impact of sitagliptin vs. placebo on cardiovascular outcomes when added to usual care in patients with type 2 diabetes. We report the use of concomitant diabetes medications and the risk for progression to insulin during follow-up. TECOS enrolled 14 671 participants with HbA1c 6.5%-8.0% on monotherapy with metformin, pioglitazone, sulfonylurea (SU), or dual therapy with two oral agents or insulin with or without metformin. Subsequent diabetes management was by the participant's usual care physician. Time to initiation of insulin and risk of hypoglycaemia were estimated using Cox proportional hazards models. The most common glucose-lowering regimens at baseline were metformin monotherapy (30.2%), SU monotherapy (8.5%), metformin/SU therapy (35.1%), and insulin with or without metformin (13.9% and 8.6%, respectively). Over a median 3.0 years' follow-up, diabetes therapy was intensified in 25.2% of participants (sitagliptin 22.0%, placebo 28.3%). Medications most commonly added were SU (8.3%) or insulin (8.8%). Insulin initiation in the usual care setting occurred at mean (standard deviation) HbA1c of 8.5 (1.5)%. Sitagliptin did not impact rates of severe...Continue Reading

References

Oct 16, 2004·The Journal of Clinical Endocrinology and Metabolism·Kathrin MaedlerMarc Y Donath
Dec 6, 2006·The New England Journal of Medicine·Steven E KahnUNKNOWN ADOPT Study Group
Jan 10, 2008·Diabetes Care·UNKNOWN American Diabetes Association
Mar 3, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Ann AlbrightDesmond E Williams
Jun 9, 2015·The New England Journal of Medicine·Jennifer B GreenUNKNOWN TECOS Study Group
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Oct 21, 2017·Diabetes, Obesity & Metabolism·David Russell-JonesKamlesh Khunti

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Citations

Apr 9, 2019·Circulation·Elisabetta PatornoSebastian Schneeweiss

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Clinical Trials Mentioned

NCT00790205

Software Mentioned

TECOS

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