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Category: Diabetes

Follow-Up of EDICT Study Demonstrates Long-Term Efficacy of Initial Combination Therapy in T2DM Management

Type 2 diabetes mellitus (T2DM) affects approximately 28 million people in the United States and is characterized by hyperglycemia due to insulin resistance and impaired β-cell function. Its prevalence has almost doubled in the last two decades and diabetes costs the economy $245 billion annually; with most of these costs attributed to T2DM. The rapid increase in both the prevalence and associated healthcare costs underscores the need for optimizing treatment, as several pharmacological agents for T2DM are currently approved, with many more in development. Due to the progressive nature of T2DM, early initiation of combination therapy has been proposed as an approach to achieve better preservation of β-cell function.

The Efficacy and Durability of Initial Combination Therapy for Type 2 Diabetes (EDICT) study was a randomized trial to evaluate the efficacy and safety of initial triple combination therapy (metformin/pioglitazone/exenatide) compared to a conventional sequential therapy (metformin, followed by sequential add-on therapy of a sulfonylurea and basal insulin) in achieving glycemic control in T2DM patients. The original results from the EDICT study, published in 2015, demonstrated that early combination therapy in recently-diagnosed (<2 years) patients led to a greater reduction in HbA1c levels compared to conventional therapy, including a 1.2 kg mean weight loss (as compared to a 4.1 kg weight gain with conventional therapy) during a follow-up time of 24 months.1 A 6-year follow-up of this study was recently presented at the 2018 American Diabetes Association in Orlando, FL. In this follow-up, subjects that received initial triple therapy experienced significantly greater reductions in HbA1c compared to conventional therapy (mean HbA1c of 5.8% vs. 6.7%, p<0.001), with more patients achieving target HbA1c levels (<6.5%) in the triple therapy group (52%) compared to conventional therapy (25%).2 In addition, patients on initial triple therapy had improved β-cell function, less episodes of hypoglycemia, and weight loss. Progression of carotid intima media thickness, a measure of subclinical atherosclerosis, was also reduced by 50% in patients receiving triple therapy.2

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Women Who Work Overtime Increase Risk of Diabetes

Working overtime may help your paycheck and give you a leg up in the office, but a new study suggests that women who log too many hours may have an increased risk of diabetes. Researchers in Canada found that woman who worked overtime increased their risk of diabetes, with published findings in Monday’s British Medical Journal Diabetes Research and Care.

Using medical records, researchers looked at the risk of developing diabetes in over 7,000 men and women ages 35 to 74 who were working different numbers of weekly hours. They found that one out of 10 people in the study developed diabetes, in particular, if they were men, older, and obese. Although women generally were less likely to get diabetes than men, here’s the interesting part: Women who worked overtime, or over 45 hours per week, were 62 percent more likely to get diabetes over those women who worked regular hours.

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