Longitudinal Effects of Glucose-Lowering Medications on β-Cell Responses and Insulin Sensitivity in Type 2 Diabetes: The GRADE Randomized Clinical Trial
Authors' conclusion
The differential long-term effects on insulin sensitivity and β-cell function of four different glucose-lowering medications when added to metformin highlight the importance of the loss of β-cell function in the progression of type 2 diabetes.
Study context
- Population
- GRADE cohort with T2D on metformin
- Participants
- 4,801 participants
- Comparison
- Insulin glargine U-100 vs glimepiride vs liraglutide vs sitagliptin, each added to metformin
- Primary endpoint
- Insulin sensitivity (HOMA2-%S) and β-cell function (HOMA2-%B; OGTT C-peptide index and total C-peptide response, adjusted for HOMA2-%S)
- Follow-up
- Baseline and 1, 3, and 5 years
Primary result
As reported in the abstract
HOMA2-%S, HOMA2-%B and C-peptide responses · 1, 3, and 5 years
- HOMA2-%S increased from baseline to year 1 with glargine and remained stable thereafter; no change from baseline in the other groups
- HOMA2-%B and C-peptide responses increased to variable degrees at year 1 in all groups, then declined progressively
- After adjustment for HOMA2-%S, the change in β-cell responses reflected that in β-cell function
Further findings
C-peptide index (CPI) · year 5 — between Liraglutide and Sitagliptin
P < 0.001
Total C-peptide response · year 5 — between Liraglutide and Sitagliptin
P < 0.001
- C-peptide index (CPI): across the four groups; CPI similar between liraglutide and sitagliptin, higher for both than glargine and glimepiride
- Total C-peptide response: across the four groups; greatest with liraglutide, then sitagliptin, glargine, glimepiride
Original publication
Longitudinal Effects of Glucose-Lowering Medications on β-Cell Responses and Insulin Sensitivity in Type 2 Diabetes: The GRADE Randomized Clinical Trial. Diabetes Care. Published 11 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →