Identifying good responders to glucose lowering therapy in type 2 diabetes: implications for stratified medicine

Defining responders to glucose lowering therapy can be important for both clinical care and for the development of a stratified approach to diabetes management. Response is commonly defined by either HbA1c change after treatment or whether a target HbA1c is achieved. We aimed to determine the extent...

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Bibliographic Details
Published in:PloS one 2014-10, Vol.9 (10), p.e111235-e111235
Main Authors: Jones, Angus G, Shields, Beverley M, Hyde, Christopher J, Henley, William E, Hattersley, Andrew T
Format: Article
Language:English
Subjects:
Agreements
Blood glucose
Blood Glucose - chemistry
C-Peptide - blood
Creatinine - blood
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - drug therapy
Diabetes therapy
Female
GLP-1 receptor agonists
Glucagon-Like Peptide 1 - agonists
Glucose
Glycated Hemoglobin A - metabolism
Hemoglobin
Humans
Hyperglycemia - blood
Identification methods
Insulin
Laboratories
Male
Medical diagnosis
Medical schools
Medicine and Health Sciences
Methods
Middle Aged
Patients
Peptides
Physical Sciences
Prospective Studies
Research and Analysis Methods
Statistical analysis
Studies
Systematic review
Therapy
Time Factors
Treatment Outcome
Triglycerides
Triglycerides - blood
Type 2 diabetes
Weight control
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Summary:Defining responders to glucose lowering therapy can be important for both clinical care and for the development of a stratified approach to diabetes management. Response is commonly defined by either HbA1c change after treatment or whether a target HbA1c is achieved. We aimed to determine the extent to which the individuals identified as responders and non-responders to glucose lowering therapy, and their characteristics, depend on the response definition chosen. We prospectively studied 230 participants commencing GLP-1 agonist therapy. We assessed participant characteristics at baseline and repeated HbA1c after 3 months treatment. We defined responders (best quartile of response) based on HbA1c change or HbA1c achieved. We assessed the extent to which these methods identified the same individuals and how this affected the baseline characteristics associated with treatment response. Different definitions of response identified different participants. Only 39% of responders by one definition were also good responders by the other. Characteristics associated with good response depend on the response definition chosen: good response by HbA1c achieved was associated with low baseline HbA1c (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0111235