Start With Three Drugs?

By David Spero A new study says that people newly diagnosed with Type 2 can do better if they are immediately started on a three-drug combo. Does this make sense to you? Is it good science or bad medicine? Muhammad A. Abdul-Ghani, MD, from the University of Texas Health Science Center at San Antonio, presented the findings at the ADA Scientific Sessions in Chicago. The study enrolled 155 people with Type 2 diabetes. The average time after diabetes diagnosis was five months. None of them were taking diabetes medications at the beginning of the trial. Their average HbA1c was 8.6%. Half the subjects got "conventional therapy." They were started on metformin. If their fasting plasma glucose (FPG) went above 100 or their A1C went above 6.5%, they were given glyburide. That's a sulfonylurea, a drug that pushes the pancreas to produce more insulin. Over a three-month period, if FPG or A1C crept up anyway, a basal insulin was added. The other group started three drugs (“triple therapy") right away. The drugs used were metformin, pioglitazone (brand name Actos), and exenatide (Byetta). Subjects were seen in the clinic every three months, where their FPG, A1C, weight, and home glucose monitoring logs were recorded. Medications could be adjusted down for blood glucose levels of less than 60 mg in a day or symptoms of hypoglycemia (low blood glucose). On the triple therapy drugs, most people were able to attain an average A1C of 6% and keep it there for two years or more. People...
Source: Diabetes Self-Management - Category: Diabetes Authors: Source Type: blogs