PodMed TT – Evaluating Second-Line Drugs for Treating Type 2 Diabetes

If you have diabetes and you’re taking metformin, and now you’ve been told you need another drug to keep your blood sugar in control, which one is best? That’s examined in a study in JAMA Open Rick and I discuss on PodMed TT this week.

The encouraging answer is the three classes of medicines are more or less similar, so after your specific risk factors are taken into account, things like tolerability and affordability can help you choose.

This study looked at a staggering 246 million patients in several cohorts and examined four outcomes: hemoglobin A1c level, kidney disorders, eye disorders, and myocardial infarction.

The three agent classes included were dipeptidyl peptidase 4 inhibitors, sulfonylureas, and thiazolidinediones.

While there were slight differences in these medicines, no major concerns were observed—although small trends did exist and may need to be examined more closely over time.

Other topics this week include the global burden of firearm death in JAMA, two studies in NEJM looking at aspirin and fish oil in people with diabetes, and rivaroxiban for prevention of blood clots after hospital discharge, also in NEJM.

Until next week, y’all listen up and make healthy choices.