Patterns of glycaemic control in patients with type 2 diabetes mellitus initiating second‐line therapy after metformin monotherapy: Retrospective data for 10256 individuals from the United Kingdom and Germany

AimTo investigate determinants of change in glycated haemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM) at 6 months after initiating uninterrupted second‐line glucose‐lowering therapies.Materials and MethodsThis cohort study utilized retrospective data from 10 256 patients with T2D...

Full description

Saved in:
Bibliographic Details
Published in:Diabetes, obesity & metabolism obesity & metabolism, 2018-02, Vol.20 (2), p.389-399
Main Authors: Khunti, Kamlesh, Godec, Thomas R, Medina, Jesús, Laura Garcia‐Alvarez, Hiller, Josh, Gomes, Marilia B, Javier Cid‐Ruzafa, Charbonnel, Bernard, Fenici, Peter, Hammar, Niklas, Hashigami, Kiyoshi, Kosiborod, Mikhail, Nicolucci, Antonio, Shestakova, Marina V, Ji, Linong, Pocock, Stuart
Format: Article
Language:English
Subjects:
Antidiabetics
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Hemoglobin
Metformin
Observational studies
Patients
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites
container_end_page 399
container_issue 2
container_start_page 389
container_title Diabetes, obesity & metabolism
container_volume 20
creator Khunti, Kamlesh
Godec, Thomas R
Medina, Jesús
Laura Garcia‐Alvarez
Hiller, Josh
Gomes, Marilia B
Javier Cid‐Ruzafa
Charbonnel, Bernard
Fenici, Peter
Hammar, Niklas
Hashigami, Kiyoshi
Kosiborod, Mikhail
Nicolucci, Antonio
Shestakova, Marina V
Ji, Linong
Pocock, Stuart
description AimTo investigate determinants of change in glycated haemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM) at 6 months after initiating uninterrupted second‐line glucose‐lowering therapies.Materials and MethodsThis cohort study utilized retrospective data from 10 256 patients with T2DM who initiated second‐line glucose‐lowering therapy (switch from or add‐on to metformin) between 2011 and 2014 in Germany and the UK. Effects of pre‐specified patient characteristics on 6‐month HbA1c changes were assessed using analysis of covariance.ResultsPatients had a mean (standard error [SE]) baseline HbA1c of 8.68% (0.02); 28.5% of patients discontinued metformin and switched to an alternative therapy and the remainder initiated add‐on therapy. Mean (SE) unadjusted 6‐month HbA1c change was −1.27% (0.02). When adjusted for baseline HbA1c, 6‐month changes depended markedly on the magnitude of the baseline HbA1c (HbA1c
doi_str_mv 10.1111/dom.13083
format article
fullrecord <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_494691</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1987979764</sourcerecordid><originalsourceid>FETCH-LOGICAL-p151t-ac90e1689b0c7870c6291d50af5f4e44fd775db65c2b79aa3f892b749cdbd4ce3</originalsourceid><addsrcrecordid>eNotj01O3zAQxaMKpAJl0RuM1HWonTgf7g6hlqIitUKwjhx7DKaJHWwHlB1H6Nk4AifptPxnFn7y_Pyepyg-cnbCqT6bMJ_wmvX1u-KAi7YueV21e_91VfaSVe-Lw5TuGWOi7ruD4uWXyhmjTxAs3E6bVjg7DTr4HMMEzsOiskOfEzy5fAd5WxAqME6NmDHBjNPk8pqIdNkR6m8hIT03r89_JucR8h1GtWygLOUQn22IM_nOwYfd7AtcIcWlBXV2jwhGZQWEAWdV05K1cY_OrGpKYGOY_1nCDeWhgR8USDuD8gbOMc7Kbx-KfUsoHu_Oo-Lm29frs-_l5c_zi7PTy3LhDc-l0pIhb3s5Mt31HdNtJblpmLKNFSiENV3XmLFtdDV2Uqna9pKUkNqMRmisj4ryzTc94bKOwxLdrOI2BOWG3dVvUjgIKVrJif_0xi8xPKyY8nAf1ujpiwOXfSepW1H_BZZYkwg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1987979764</pqid></control><display><type>article</type><title>Patterns of glycaemic control in patients with type 2 diabetes mellitus initiating second‐line therapy after metformin monotherapy: Retrospective data for 10256 individuals from the United Kingdom and Germany</title><source>Wiley-Blackwell Read &amp; Publish Collection</source><creator>Khunti, Kamlesh ; Godec, Thomas R ; Medina, Jesús ; Laura Garcia‐Alvarez ; Hiller, Josh ; Gomes, Marilia B ; Javier Cid‐Ruzafa ; Charbonnel, Bernard ; Fenici, Peter ; Hammar, Niklas ; Hashigami, Kiyoshi ; Kosiborod, Mikhail ; Nicolucci, Antonio ; Shestakova, Marina V ; Ji, Linong ; Pocock, Stuart</creator><creatorcontrib>Khunti, Kamlesh ; Godec, Thomas R ; Medina, Jesús ; Laura Garcia‐Alvarez ; Hiller, Josh ; Gomes, Marilia B ; Javier Cid‐Ruzafa ; Charbonnel, Bernard ; Fenici, Peter ; Hammar, Niklas ; Hashigami, Kiyoshi ; Kosiborod, Mikhail ; Nicolucci, Antonio ; Shestakova, Marina V ; Ji, Linong ; Pocock, Stuart</creatorcontrib><description>AimTo investigate determinants of change in glycated haemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM) at 6 months after initiating uninterrupted second‐line glucose‐lowering therapies.Materials and MethodsThis cohort study utilized retrospective data from 10 256 patients with T2DM who initiated second‐line glucose‐lowering therapy (switch from or add‐on to metformin) between 2011 and 2014 in Germany and the UK. Effects of pre‐specified patient characteristics on 6‐month HbA1c changes were assessed using analysis of covariance.ResultsPatients had a mean (standard error [SE]) baseline HbA1c of 8.68% (0.02); 28.5% of patients discontinued metformin and switched to an alternative therapy and the remainder initiated add‐on therapy. Mean (SE) unadjusted 6‐month HbA1c change was −1.27% (0.02). When adjusted for baseline HbA1c, 6‐month changes depended markedly on the magnitude of the baseline HbA1c (HbA1c &lt;9%, −0.45% per unit increase in HbA1c; HbA1c ≥9%, −0.87% per unit increase in HbA1c). Adjusted mean 6‐month HbA1c reductions showed slight treatment differences (range, 0.92–1.09%; P &lt; .001). Greater reductions in HbA1c were associated with second‐line treatment initiation within 6 months of T2DM diagnosis (1.36% vs 1.03% [P &lt; .001]) and advanced age (≥70 years, 1.13%; &lt;70 years, 1.02% [P &lt; .001]).ConclusionsMany patients with T2DM have very high HbA1c levels when initiating second‐line therapy, indicating the need for earlier treatment intensification. Patient‐specific factors merit consideration when making treatment decisions.</description><identifier>ISSN: 1462-8902</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.13083</identifier><language>eng</language><publisher>Oxford: Wiley Subscription Services, Inc</publisher><subject>Antidiabetics ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Hemoglobin ; Metformin ; Observational studies ; Patients</subject><ispartof>Diabetes, obesity &amp; metabolism, 2018-02, Vol.20 (2), p.389-399</ispartof><rights>2017. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:137427605$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Khunti, Kamlesh</creatorcontrib><creatorcontrib>Godec, Thomas R</creatorcontrib><creatorcontrib>Medina, Jesús</creatorcontrib><creatorcontrib>Laura Garcia‐Alvarez</creatorcontrib><creatorcontrib>Hiller, Josh</creatorcontrib><creatorcontrib>Gomes, Marilia B</creatorcontrib><creatorcontrib>Javier Cid‐Ruzafa</creatorcontrib><creatorcontrib>Charbonnel, Bernard</creatorcontrib><creatorcontrib>Fenici, Peter</creatorcontrib><creatorcontrib>Hammar, Niklas</creatorcontrib><creatorcontrib>Hashigami, Kiyoshi</creatorcontrib><creatorcontrib>Kosiborod, Mikhail</creatorcontrib><creatorcontrib>Nicolucci, Antonio</creatorcontrib><creatorcontrib>Shestakova, Marina V</creatorcontrib><creatorcontrib>Ji, Linong</creatorcontrib><creatorcontrib>Pocock, Stuart</creatorcontrib><title>Patterns of glycaemic control in patients with type 2 diabetes mellitus initiating second‐line therapy after metformin monotherapy: Retrospective data for 10256 individuals from the United Kingdom and Germany</title><title>Diabetes, obesity &amp; metabolism</title><description>AimTo investigate determinants of change in glycated haemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM) at 6 months after initiating uninterrupted second‐line glucose‐lowering therapies.Materials and MethodsThis cohort study utilized retrospective data from 10 256 patients with T2DM who initiated second‐line glucose‐lowering therapy (switch from or add‐on to metformin) between 2011 and 2014 in Germany and the UK. Effects of pre‐specified patient characteristics on 6‐month HbA1c changes were assessed using analysis of covariance.ResultsPatients had a mean (standard error [SE]) baseline HbA1c of 8.68% (0.02); 28.5% of patients discontinued metformin and switched to an alternative therapy and the remainder initiated add‐on therapy. Mean (SE) unadjusted 6‐month HbA1c change was −1.27% (0.02). When adjusted for baseline HbA1c, 6‐month changes depended markedly on the magnitude of the baseline HbA1c (HbA1c &lt;9%, −0.45% per unit increase in HbA1c; HbA1c ≥9%, −0.87% per unit increase in HbA1c). Adjusted mean 6‐month HbA1c reductions showed slight treatment differences (range, 0.92–1.09%; P &lt; .001). Greater reductions in HbA1c were associated with second‐line treatment initiation within 6 months of T2DM diagnosis (1.36% vs 1.03% [P &lt; .001]) and advanced age (≥70 years, 1.13%; &lt;70 years, 1.02% [P &lt; .001]).ConclusionsMany patients with T2DM have very high HbA1c levels when initiating second‐line therapy, indicating the need for earlier treatment intensification. Patient‐specific factors merit consideration when making treatment decisions.</description><subject>Antidiabetics</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Hemoglobin</subject><subject>Metformin</subject><subject>Observational studies</subject><subject>Patients</subject><issn>1462-8902</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNotj01O3zAQxaMKpAJl0RuM1HWonTgf7g6hlqIitUKwjhx7DKaJHWwHlB1H6Nk4AifptPxnFn7y_Pyepyg-cnbCqT6bMJ_wmvX1u-KAi7YueV21e_91VfaSVe-Lw5TuGWOi7ruD4uWXyhmjTxAs3E6bVjg7DTr4HMMEzsOiskOfEzy5fAd5WxAqME6NmDHBjNPk8pqIdNkR6m8hIT03r89_JucR8h1GtWygLOUQn22IM_nOwYfd7AtcIcWlBXV2jwhGZQWEAWdV05K1cY_OrGpKYGOY_1nCDeWhgR8USDuD8gbOMc7Kbx-KfUsoHu_Oo-Lm29frs-_l5c_zi7PTy3LhDc-l0pIhb3s5Mt31HdNtJblpmLKNFSiENV3XmLFtdDV2Uqna9pKUkNqMRmisj4ryzTc94bKOwxLdrOI2BOWG3dVvUjgIKVrJif_0xi8xPKyY8nAf1ujpiwOXfSepW1H_BZZYkwg</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Khunti, Kamlesh</creator><creator>Godec, Thomas R</creator><creator>Medina, Jesús</creator><creator>Laura Garcia‐Alvarez</creator><creator>Hiller, Josh</creator><creator>Gomes, Marilia B</creator><creator>Javier Cid‐Ruzafa</creator><creator>Charbonnel, Bernard</creator><creator>Fenici, Peter</creator><creator>Hammar, Niklas</creator><creator>Hashigami, Kiyoshi</creator><creator>Kosiborod, Mikhail</creator><creator>Nicolucci, Antonio</creator><creator>Shestakova, Marina V</creator><creator>Ji, Linong</creator><creator>Pocock, Stuart</creator><general>Wiley Subscription Services, Inc</general><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20180201</creationdate><title>Patterns of glycaemic control in patients with type 2 diabetes mellitus initiating second‐line therapy after metformin monotherapy: Retrospective data for 10256 individuals from the United Kingdom and Germany</title><author>Khunti, Kamlesh ; Godec, Thomas R ; Medina, Jesús ; Laura Garcia‐Alvarez ; Hiller, Josh ; Gomes, Marilia B ; Javier Cid‐Ruzafa ; Charbonnel, Bernard ; Fenici, Peter ; Hammar, Niklas ; Hashigami, Kiyoshi ; Kosiborod, Mikhail ; Nicolucci, Antonio ; Shestakova, Marina V ; Ji, Linong ; Pocock, Stuart</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p151t-ac90e1689b0c7870c6291d50af5f4e44fd775db65c2b79aa3f892b749cdbd4ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Antidiabetics</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Hemoglobin</topic><topic>Metformin</topic><topic>Observational studies</topic><topic>Patients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khunti, Kamlesh</creatorcontrib><creatorcontrib>Godec, Thomas R</creatorcontrib><creatorcontrib>Medina, Jesús</creatorcontrib><creatorcontrib>Laura Garcia‐Alvarez</creatorcontrib><creatorcontrib>Hiller, Josh</creatorcontrib><creatorcontrib>Gomes, Marilia B</creatorcontrib><creatorcontrib>Javier Cid‐Ruzafa</creatorcontrib><creatorcontrib>Charbonnel, Bernard</creatorcontrib><creatorcontrib>Fenici, Peter</creatorcontrib><creatorcontrib>Hammar, Niklas</creatorcontrib><creatorcontrib>Hashigami, Kiyoshi</creatorcontrib><creatorcontrib>Kosiborod, Mikhail</creatorcontrib><creatorcontrib>Nicolucci, Antonio</creatorcontrib><creatorcontrib>Shestakova, Marina V</creatorcontrib><creatorcontrib>Ji, Linong</creatorcontrib><creatorcontrib>Pocock, Stuart</creatorcontrib><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Diabetes, obesity &amp; metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khunti, Kamlesh</au><au>Godec, Thomas R</au><au>Medina, Jesús</au><au>Laura Garcia‐Alvarez</au><au>Hiller, Josh</au><au>Gomes, Marilia B</au><au>Javier Cid‐Ruzafa</au><au>Charbonnel, Bernard</au><au>Fenici, Peter</au><au>Hammar, Niklas</au><au>Hashigami, Kiyoshi</au><au>Kosiborod, Mikhail</au><au>Nicolucci, Antonio</au><au>Shestakova, Marina V</au><au>Ji, Linong</au><au>Pocock, Stuart</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patterns of glycaemic control in patients with type 2 diabetes mellitus initiating second‐line therapy after metformin monotherapy: Retrospective data for 10256 individuals from the United Kingdom and Germany</atitle><jtitle>Diabetes, obesity &amp; metabolism</jtitle><date>2018-02-01</date><risdate>2018</risdate><volume>20</volume><issue>2</issue><spage>389</spage><epage>399</epage><pages>389-399</pages><issn>1462-8902</issn><eissn>1463-1326</eissn><abstract>AimTo investigate determinants of change in glycated haemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM) at 6 months after initiating uninterrupted second‐line glucose‐lowering therapies.Materials and MethodsThis cohort study utilized retrospective data from 10 256 patients with T2DM who initiated second‐line glucose‐lowering therapy (switch from or add‐on to metformin) between 2011 and 2014 in Germany and the UK. Effects of pre‐specified patient characteristics on 6‐month HbA1c changes were assessed using analysis of covariance.ResultsPatients had a mean (standard error [SE]) baseline HbA1c of 8.68% (0.02); 28.5% of patients discontinued metformin and switched to an alternative therapy and the remainder initiated add‐on therapy. Mean (SE) unadjusted 6‐month HbA1c change was −1.27% (0.02). When adjusted for baseline HbA1c, 6‐month changes depended markedly on the magnitude of the baseline HbA1c (HbA1c &lt;9%, −0.45% per unit increase in HbA1c; HbA1c ≥9%, −0.87% per unit increase in HbA1c). Adjusted mean 6‐month HbA1c reductions showed slight treatment differences (range, 0.92–1.09%; P &lt; .001). Greater reductions in HbA1c were associated with second‐line treatment initiation within 6 months of T2DM diagnosis (1.36% vs 1.03% [P &lt; .001]) and advanced age (≥70 years, 1.13%; &lt;70 years, 1.02% [P &lt; .001]).ConclusionsMany patients with T2DM have very high HbA1c levels when initiating second‐line therapy, indicating the need for earlier treatment intensification. Patient‐specific factors merit consideration when making treatment decisions.</abstract><cop>Oxford</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/dom.13083</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1462-8902
ispartof Diabetes, obesity & metabolism, 2018-02, Vol.20 (2), p.389-399
issn 1462-8902
1463-1326
language eng
recordid cdi_swepub_primary_oai_swepub_ki_se_494691
source Wiley-Blackwell Read & Publish Collection
subjects Antidiabetics
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Hemoglobin
Metformin
Observational studies
Patients
title Patterns of glycaemic control in patients with type 2 diabetes mellitus initiating second‐line therapy after metformin monotherapy: Retrospective data for 10256 individuals from the United Kingdom and Germany
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T19%3A29%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Patterns%20of%20glycaemic%20control%20in%20patients%20with%20type%202%20diabetes%20mellitus%20initiating%20second%E2%80%90line%20therapy%20after%20metformin%20monotherapy:%20Retrospective%20data%20for%2010256%20individuals%20from%20the%20United%20Kingdom%20and%20Germany&rft.jtitle=Diabetes,%20obesity%20&%20metabolism&rft.au=Khunti,%20Kamlesh&rft.date=2018-02-01&rft.volume=20&rft.issue=2&rft.spage=389&rft.epage=399&rft.pages=389-399&rft.issn=1462-8902&rft.eissn=1463-1326&rft_id=info:doi/10.1111/dom.13083&rft_dat=%3Cproquest_swepu%3E1987979764%3C/proquest_swepu%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-p151t-ac90e1689b0c7870c6291d50af5f4e44fd775db65c2b79aa3f892b749cdbd4ce3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1987979764&rft_id=info:pmid/&rfr_iscdi=true