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...
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BMJ Publishing Group
2025-04-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/13/2/e004981.full |
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| author | JOHN ADAMS Ralph A DeFronzo Aurora Merovci Curtis Triplitt Muhammad Abdul-Ghani Curtiss Puckett Siham Abdelgani Olga Lavrynenko |
| author_facet | JOHN ADAMS Ralph A DeFronzo Aurora Merovci Curtis Triplitt Muhammad Abdul-Ghani Curtiss Puckett Siham Abdelgani Olga Lavrynenko |
| author_sort | JOHN ADAMS |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-1034cef8eac94a99a1acbed2be5fcae8 |
| institution | OA Journals |
| issn | 2052-4897 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj-art-1034cef8eac94a99a1acbed2be5fcae82025-08-20T02:33:23ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972025-04-0113210.1136/bmjdrc-2025-004981Glycemic and non-glycemic benefits of initial triple therapy versus sequential add-on therapy in patients with new-onset diabetes: results from the EDICT studyJOHN ADAMS0Ralph A DeFronzo1Aurora Merovci2Curtis Triplitt3Muhammad Abdul-Ghani4Curtiss Puckett5Siham Abdelgani6Olga Lavrynenko7Diabetes Division, UT Health San Antonio, San Antonio, Texas, USADiabetes Division, UT Health San Antonio, San Antonio, Texas, USADiabetes Division, UT Health San Antonio, San Antonio, Texas, USADiabetes Division, UT Health San Antonio, San Antonio, Texas, USADiabetes Division, UT Health San Antonio, San Antonio, Texas, USADiabetes Division, UT Health San Antonio, San Antonio, Texas, USADiabetes Division, UT Health San Antonio, San Antonio, Texas, USADiabetes Division, UT Health San Antonio, San Antonio, Texas, USAIntroduction 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.https://drc.bmj.com/content/13/2/e004981.full |
| spellingShingle | JOHN ADAMS Ralph A DeFronzo Aurora Merovci Curtis Triplitt Muhammad Abdul-Ghani Curtiss Puckett Siham Abdelgani Olga Lavrynenko 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 BMJ Open Diabetes Research & Care |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://drc.bmj.com/content/13/2/e004981.full |
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