Differential Effects of Type 2 Diabetes Treatment Regimens on Diabetes Distress and Depressive Symptoms in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE)
Authors' conclusion
Contrary to expectations, this randomized trial found no evidence for a deleterious effect of basal insulin on emotional distress. Glargine lowered diabetes distress modestly at 1 year rather than increasing it. Liraglutide also reduced diabetes distress at 1 year. Results can inform treatment decisions for adults with early T2DM.
Study context
- Population
- Adults with T2D of <10 years' duration, HbA1c 6.8–8.5%, on metformin monotherapy; mean (SD) age 58.0 (10.2) years, 32% femaleEmotional Distress Substudy
- Participants
- 1,739 adults
- Comparison
- Insulin glargine vs glimepiride vs liraglutide vs sitagliptin, each added to metformin
- Primary endpoint
- Diabetes distress and depressive symptoms (emotional distress), assessed every 6 months
- Follow-up
- 1 year and over 3-year follow-up
Methodological detailscomparative effectiveness, Emotional Distress Substudy
- Comparative effectiveness
- Emotional Distress Substudy
Primary result
As reported in the abstract
Difference
−0.10
P = 0.002
Glargine vs Other groups combined
Difference
−0.10
P = 0.008
Liraglutide vs Glimepiride or sitagliptin
Further findings
Change across treatments in diabetes distress and depressive symptoms · 1 year
- Diabetes distress decreased
- −0.24, P < 0.0001
- Depressive symptoms decreased
- −0.67, P < 0.0001
Diabetes distress over follow-up · 3-year follow-up
- No significant group differences in total diabetes distress
- Interpersonal diabetes distress remained lower with liraglutide
Depressive symptoms
- No significant differences between groups
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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