Between 2007 and 2014, more Medicare beneficiaries were newly prescribed metformin, dipeptidyl peptidase-4 inhibitors, and sodium-glucose cotransporter 2 inhibitors, while fewer received long-acting sulfonylureas or thiazolidinediones.
After four years of follow-up, patients who had received intensive treatment during the trial had similar systolic blood pressure (BP) to those who had been on standard treatment but lower rates of cardiovascular (CV) events.
Patients with type 2 diabetes who had Roux-en-Y gastric bypass surgery maintained significant, although shrinking, improvements in HbA1c compared to those receiving lifestyle and medical management.
The researchers found an inverse association between insulin initiation and age, and black and Hispanic participants were less likely to have insulin initiated compared with white participants.
A cost-effectiveness analysis found that individualized control saved $13,547 per patient compared with uniform intensive control, primarily due to lower medication costs, and increased quality-adjusted life-years by 0.10.
Participants were randomized to receive either ezetimibe or placebo in addition to background simvastatin, and the subgroup of patients with diabetes was compared to those without the disease.
The most important predictors of the trajectory of glucose control were body mass index and levels of HbA1c and triglycerides, according to the study of registry data from the Netherlands.
From 2000 to 2014, the age-standardized incidence of end-stage renal disease (ESRD) attributed to diabetes decreased from 260.2 to 173.9 per 100,000 diabetic population.
A limitation of the industry-funded randomized trial was the high rate of early discontinuation: 43.0% of patients on exenatide and 45.2% of those on placebo.
Risk of atrial fibrillation increased with worse glycemic control and renal complications. Among patients with normoalbuminuria, researchers found no excess risk of atrial fibrillation with an HbA1c less than 9.7% for men or 8.8% for women.