Early Glycemic Response Predicts Achievement of Subsequent Treatment Targets in the Treatment of Type 2 Diabetes: A Post hoc Analysis

• Published in: Diabetes therapy 2015-09, Vol.6 (3), p.317-328
• Main Authors: Fu, Haoda, Cao, Dachuang, Boye, Kristina S., Curtis, Bradley, Schuster, Dara L., Kendall, David M., Ascher-Svanum, Haya
• Format: Article
• Language: English
• Subjects: Cardiology; Diabetes; Endocrinology; Internal Medicine; Medicine; Medicine & Public Health; Original Research; Personalized medicine
• ISSN: 1869-6953; 1869-6961
• DOI: 10.1007/s13300-015-0119-x

Introduction American Diabetes Association consensus guidelines emphasize individualized treatment in the management of type 2 diabetes mellitus (T2DM). Early glycemic response is a clinical marker that may predict longer term efficacy for individual patients and provide a clinical tool to enhance personalized treatment. This analysis evaluated whether glycemic response measured at week 12 (“early”) could serve as a reliable predictor of glycemic control at weeks 24 and 52 of therapy in patients with T2DM. Methods We used data from 3 randomized, controlled clinical trials that evaluated patients with T2DM treated with 3 commonly prescribed glucose-lowering medications: metformin ( n  = 597), sulfonylurea ( n  = 626), and insulin glargine ( n  = 1046). The gradient boosting method was used to identify predictors of subsequent response; predictive accuracy was represented by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Treatment success at weeks 24 and 52 was assessed for each patient and defined as achieving a glycated hemoglobin (HbA 1c ) level of