Glycemic control over 5 years in 4,900 people with type 2 diabetes: real-world diabetes therapy in a clinical trial cohort.

Best, J; Drury, P; Davis, T; Taskinen, MR; Kesäniemi, Y; Scott, R; Pardy, C; Voysey, M; Keech, A

Journal article

Glycemic control over 5 years in 4,900 people with type 2 diabetes: real-world diabetes therapy in a clinical trial cohort.

Abstract:: OBJECTIVE: Glycemic control in type 2 diabetes generally worsens over time, requiring intensification of therapy. The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial provided the opportunity to observe glycemic control in a real-world setting. We assessed the adequacy of metformin, sulfonylureas, and insulin to maintain glycemic control and their effects on weight. RESEARCH DESIGN AND METHODS: Diabetes control was measured at baseline and yearly for a median of 5 years in the 4,900 patients from the nonintervention arm of this study allocated to placebo. RESULTS: Median HbA(1c) was 6.9% at baseline and increased by an average of 0.22% over 5 years (P < 0.001). Median weight was 86.3 kg at baseline and decreased by 0.4 kg over 5 years (P = 0.002). Baseline therapy was lifestyle measures only in 27%, oral agents without insulin in 59%, and insulin in 14% (7% also taking oral agents). Over 5 years, insulin use increased to 32% (21% also taking oral agents). Use of oral agents remained similar at 56%. Only 2% of patients at baseline and 4% after 5 years were taking oral agents other than metformin or sulfonylureas. Initiation of insulin therapy in 855 patients produced a sustained reduction of HbA(1c) from a median of 8.2 to 7.7%, with a weight gain of 4.6 kg over 5 years. CONCLUSIONS: With intensification of traditional therapies, glycemic control deteriorated very little over 5 years in a large cohort of type 2 diabetes. However, the requirement for insulin therapy doubled, at the expense of significant weight gain and risk of hypoglycemia.

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APA Style

Best, J., Drury, P., Davis, T., Taskinen, M. R., Kesäniemi, Y., Scott, R., Pardy, C., Voysey, M., & Keech, A. (2012). Glycemic control over 5 years in 4,900 people with type 2 diabetes: real-world diabetes therapy in a clinical trial cohort. Diabetes Care, 35(5), 1165–1170.

MLA Style

Best, J, et al. “Glycemic Control over 5 Years in 4,900 People with Type 2 Diabetes: Real-World Diabetes Therapy in a Clinical Trial Cohort.” Diabetes Care, vol. 35, no. 5, 2012, pp. 1165–70.

Chicago Style

Best, J, P Drury, T Davis, et al. 2012. “Glycemic Control over 5 Years in 4,900 People with Type 2 Diabetes: Real-World Diabetes Therapy in a Clinical Trial Cohort.” Diabetes Care 35 (5): 1165–70.
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