Glycemic and non-glycemic benefits of initial triple therapy versus sequential add-on therapy in patients with new-onset diabetes: results from the EDICT study

Introduction To compare carotid intima–media thickness (cIMT) and liver fat content in subjects who maintained good glycemic control for 6 years on initial triple therapy with metformin/exenatide/pioglitazone versus sequential add-on therapy with metformin followed with glipizide and basal insulin i...

Full description

Saved in:
Bibliographic Details
Main Authors: JOHN ADAMS, Ralph A DeFronzo, Aurora Merovci, Curtis Triplitt, Muhammad Abdul-Ghani, Curtiss Puckett, Siham Abdelgani, Olga Lavrynenko
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/13/2/e004981.full
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction To compare carotid intima–media thickness (cIMT) and liver fat content in subjects who maintained good glycemic control for 6 years on initial triple therapy with metformin/exenatide/pioglitazone versus sequential add-on therapy with metformin followed with glipizide and basal insulin in subjects with new-onset diabetes.Research design and methods Liver fat content and cIMT were compared among patients with T2DM who received initial triple therapy with metformin/pioglitazone/exenatide (n=29) versus metformin, followed by stepwise addition of glipizide and then insulin glargine (n=26) and who maintained HbA1c<6.5% for 6 years in Efficacy and Durability of Initial Combination Therapy for Type 2 Diabetes.Results After 6 years in subjects receiving initial triple therapy with metformin/pioglitazone/exenatide and subjects receiving sequential addition of metformin followed by glipizide and insulin glargine had a mean HbA1c of 5.7% vs 6.0%, respectively, p=NS. Nonetheless, subjects receiving sequential add-on therapy experienced a greater increase in cIMT and manifested greater liver fat content and fibrosis than subjects receiving initial triple therapy.Conclusions Including pioglitazone plus exenatide in the glucose-lowering regimen slows the progression of cIMT and was associated with lower hepatic fat content and fibrosis compared with subjects receiving sequential add-on therapy without pioglitazone and exenatide despite comparable optimal glycemic control.Trial registration number NCT01107717.
ISSN:2052-4897