Dual therapy appears superior to monotherapy for low-income individuals with newly diagnosed type 2 diabetes

Elizabeth M. Vaughan, Craig A. Johnston, David J. Hyman, Daphne C. Hernandez, Vagish S. Hemmige, John P. Foreyt

Research output: Contribution to journalArticle

Abstract

Background: There are variable recommendations regarding initiating monotherapy or dual therapy in patients with newly diagnosed type 2 diabetes (T2D). Clear initial strategies are of particular importance in underserved settings where access to care and financial burdens are significant barriers. Objectives: To provide descriptive data of metabolic outcomes to therapy regimens for low-income individuals with newly diagnosed T2D placed on oral hypoglycemic agents (OAs). Methods: We conducted a retrospective chart review of low-income individuals with newly diagnosed T2D initiated on OAs. We provided descriptive data and then evaluated the effects of OA regimens (ie, mono-, dual-, transition [from mono to dual or vice versa] therapy) on hemoglobin A1c (A1c) (baseline to 12 months). Results: A total of 309 patients were included in the study. At 12 months, the mean decrease in A1c for the entire sample was −2.36% (9.37% to 7.01%). Patients prescribed dual therapy had a greater change of A1c compared to those taking monotherapy with metformin (−1.11%, P < .01). Patients who transitioned therapies did not differ in change of A1c compared to monotherapy. Conclusion: Initiation of dual therapy was superior to metformin monotherapy or transitioning therapies and may be preferred for low-income individuals with newly diagnosed T2D.

Original languageEnglish (US)
Pages (from-to)305-311
Number of pages7
JournalJournal of Primary Care and Community Health
Volume8
Issue number4
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

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Type 2 Diabetes Mellitus
Hypoglycemic Agents
Metformin
Therapeutics
Hemoglobins

Keywords

  • Chronic disease
  • Community health centers
  • Diabetes
  • Low-income settings
  • Medications
  • Newly diagnosed
  • Oral hypoglycemic agent
  • Underserved

ASJC Scopus subject areas

  • Community and Home Care
  • Public Health, Environmental and Occupational Health

Cite this

Dual therapy appears superior to monotherapy for low-income individuals with newly diagnosed type 2 diabetes. / Vaughan, Elizabeth M.; Johnston, Craig A.; Hyman, David J.; Hernandez, Daphne C.; Hemmige, Vagish S.; Foreyt, John P.

In: Journal of Primary Care and Community Health, Vol. 8, No. 4, 01.10.2017, p. 305-311.

Research output: Contribution to journalArticle

Vaughan, Elizabeth M. ; Johnston, Craig A. ; Hyman, David J. ; Hernandez, Daphne C. ; Hemmige, Vagish S. ; Foreyt, John P. / Dual therapy appears superior to monotherapy for low-income individuals with newly diagnosed type 2 diabetes. In: Journal of Primary Care and Community Health. 2017 ; Vol. 8, No. 4. pp. 305-311.
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abstract = "Background: There are variable recommendations regarding initiating monotherapy or dual therapy in patients with newly diagnosed type 2 diabetes (T2D). Clear initial strategies are of particular importance in underserved settings where access to care and financial burdens are significant barriers. Objectives: To provide descriptive data of metabolic outcomes to therapy regimens for low-income individuals with newly diagnosed T2D placed on oral hypoglycemic agents (OAs). Methods: We conducted a retrospective chart review of low-income individuals with newly diagnosed T2D initiated on OAs. We provided descriptive data and then evaluated the effects of OA regimens (ie, mono-, dual-, transition [from mono to dual or vice versa] therapy) on hemoglobin A1c (A1c) (baseline to 12 months). Results: A total of 309 patients were included in the study. At 12 months, the mean decrease in A1c for the entire sample was −2.36{\%} (9.37{\%} to 7.01{\%}). Patients prescribed dual therapy had a greater change of A1c compared to those taking monotherapy with metformin (−1.11{\%}, P < .01). Patients who transitioned therapies did not differ in change of A1c compared to monotherapy. Conclusion: Initiation of dual therapy was superior to metformin monotherapy or transitioning therapies and may be preferred for low-income individuals with newly diagnosed T2D.",
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