VIDEO: Head-to-head trial shows GLP-1 agonist, insulin most effective for diabetes
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In this video exclusive, Richard E. Pratley, MD, talks with Deborah J. Wexler, MD, MSc, about results and implications of the long-term GRADE study comparing the effectiveness of second-line diabetes agents in conjunction with metformin.
Pratley is the Samuel E. Crockett Chair in Diabetes Research and medical director of AdventHealth Diabetes Institute, and Wexler is associate professor of medicine at Harvard Medical School, the associate clinical chief of the MGH Diabetes Unit, and clinical director of the MGH Diabetes Center.
GRADE demonstrated that, over a mean period of 4 years among more than 5,000 participants, the GLP1 receptor agonist liraglutide and insulin glargine were more effective for maintaining HbA1c below 7% and below 7.5% than the sulfonylurea glimepiride and the DPP4 inhibitor sitagliptin.
Pratley and Wexler discuss the differences in study design between GRADE and other large trials, including more recent cardiovascular outcome trials, the different effects of the drugs on weight and hypoglycemia, and the future of individualized diabetes treatment.
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