When patients are diagnosed with diabetes type 2, and are given the drug metformin (Glucophage) to lower their blood sugar, they are much less likely to need a second oral medication or insulin to control blood sugar than patients who are prescribed other blood-sugar-lowering medications, a new study indicates.
Metformin is the first choice drug of treatment to lower blood sugar levels in type 2 diabetic patients by the American Diabetes Association, the American College of Physicians, and others.
Researchers Seth A. Berkowitz, MD, MPH, of Brigham and Women’s Hospital and Harvard Medical School in Boston, and colleagues looked at the initial choice of a blood-sugar-lowering medication and how long it took before patients required an additional medication to lower blood sugar, according to a news release. The researchers evaluated data from 15,516 patients with type 2 diabetes who were insured and who had been prescribed a medication to lower blood sugar between 2009 and 2013.
A total of 8,964 patients (57.8 percent) started taking metformin for newly diagnosed diabetes. Other classes of medications prescribed to newly diagnosed patients instead of metformin were:
- sulfonylureas, such as glyburide (Diabeta) therapy in 3,570 patients (23 percent)
- DPP-4 inhibitors such as sitagliptin (Januvia) in 2,034 patients (13.1 percent).
- thiazolidinediones such as pioglitazone (Actos) in 948 patients (6.1 percent)
Patients prescribed metformin only were less likely to require extra treatment with additional medications compared with those who used the other medications alone. Although 2,198 patients (24.5 percent) on metformin needed a second oral medication to fully maintain blood-sugar levels, 39.6 percent who were prescribed a thiazolidinedione, 37.1 percent of patients given a sulfonylurea, and 36.2 percent taking a DPP-4 inhibitor required a second oral medication.
Additionally, 5.1 percent of patients prescribed metformin needed insulin added to their regimen compared to 9.1 percent of patients who received a sulfonylurea, 6.2 percent given thiazolidinediones, and 5.6 percent prescribed a DPP-4 inhibitor.
“Despite guidelines [recommending metformin], only 57.8 percent of individuals began diabetes treatment with metformin,” the researchers write. “Beginning treatment with metformin was associated with reduced subsequent treatment intensification, without differences in rates of hypoglycemia or other adverse clinical events. These findings have significant implications for quality of life and medication costs.”