Predicting post one-year durability of glucose-lowering monotherapies in patients with newly-diagnosed type 2 diabetes mellitus – A MASTERMIND precision medicine approach (UKPDS 87)

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Olorunsola F Agbaje 1, Ruth L Coleman 2, Andrew T Hattersley 3, Angus G Jones 3, Ewan R Pearson 4, Beverley M Shields 3, Rury R Holman 2, MASTERMIND consortium

Main idea: Post one-year glycaemic durability can be predicted robustly in individuals with newly-diagnosed T2D who achieve HbA1c values < 7.5% one year after commencing traditional monotherapies. Such information could be used to help guide glycaemic management for individual patients.

Abstract

Aims: Predicting likely durability of glucose-lowering therapies for people with type 2 diabetes (T2D) could help inform individualised therapeutic choices.

Methods: We used data from UKPDS patients with newly-diagnosed T2D randomised to first-line glucose-lowering monotherapy with chlorpropamide-glibenclamide-basal insulin or metformin. We assessed relationships between one-year characteristics and time to monotherapy-failure.

Results: Follow-up was median (IQR) 11.0 (8.0-14.0) years. Monotherapy-failure occurred in 72%-82%-75% and 79% for those randomised to chlorpropamide-glibenclamide-basal insulin or metformin. Time-to-monotherapy- failure was predicted primarily by HbA1c and BMI values.

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