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- November 21, 2008 |
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"What is the rationale for earlier use of oral antidiabetic combination therapy?"Dr. Steven V. Edelman (biography)
English - 2004-06-04 - 19 minutes
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Summary :
Dr. Edelman reviews the mechanism of action of various oral antidiabetic agents and discusses their relative significance in the prevention of type 2 diabetes as shown in clinical trials.
Data from DeFronzo et al. published in 1995 showed the superior glucose-lowering efficacy of adding metformin to glyburide compared to using glyburide alone or metformin alone. A more recent study by Garber et al. showed superior glycemic control achieved with glyburide/metformin tablets compared to monotherapy with either agent.
The UKPD Study showed a deterioration in glycemic control with monotherapy using different agents, and these patients were treated at a late stage in the natural history of their diabetes, when their beta cell function had already declined substantially.
Copyright © 2004 E-MedHosting.com Inc.
Learning objectives :
After viewing these slides the participant will be able to discuss:
- The mechanism of action of different oral antidiabetic agents
- Data relating to the benefit of combination therapy versus uptitration or switching of agents in monotherapy
Bibliographic references :
ADA.Standards of Medical Care for Patients With Diabetes Mellitus Diabetes Care 2002;25:S33-S49.
Ralph A. DeFronzo, M.D., Anita M. Goodman, M.D., for The Multicenter Metformin Study Group. Efficacy of Metformin in Patients with Non-Insulin-Dependent Diabetes MellitusNEJM. 1995;333:541-549.
Alan J. Garber, Daniel S. Donovan, Jr., Paresh Dandona, Simon Bruce and Jong-Soon Park.Efficacy of Glyburide/Metformin Tablets Compared with Initial Monotherapy in Type 2 Diabetes JCEM 2003;Vol. 88, No. 8 3598-3604.
UK Prospective Diabetes Study (UKPDS) Group.Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) The Lancet 1998;352(9131):854-865.
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