Diabetes treatment

Association of Hemoglobin A_1c Levels With Use of Sulfonylureas, Dipeptidyl Peptidase 4 Inhibitors, and Thiazolidinediones in Patients With Type 2 Diabetes Treated With MetforminAnalysis From the Observational Health Data Sciences and Informatics Initiative

Rohit Vashisht, PhD^1,2; Kenneth Jung, PhD^1,2; Alejandro Schuler, MS^1,2; et alJuan M. Banda, PhD^1,2; Rae Woong Park, MD, PhD^1,3,4; Sanghyung Jin, MS^1,4; Li Li, MS, MD⁵; Joel T. Dudley, PhD⁵; Kipp W. Johnson, MD, PhD⁵; Mark M. Shervey, PhD⁵; Hua Xu, PhD^1,6; Yonghui Wu, PhD^1,7; Karthik Natrajan, PhD^1,8,9; George Hripcsak, MD, MS^1,9; Peng Jin, MS^1,9; Mui Van Zandt, BS^1,10; Anthony Reckard, BS^1,10; Christian G. Reich, MD^1,10; James Weaver, MPH, MS^1,11; Martijn J. Schuemie, PhD¹¹; Patrick B. Ryan, PhD^1,9,11; Alison Callahan, PhD^1,2; Nigam H. Shah, MBBS, PhD^1,2

Author Affiliations Article Information

JAMA Network Open. 2018;1(4):e181755. doi:10.1001/jamanetworkopen.2018.1755

Key Points

Question  Can the effectiveness of second-line treatment of type 2 diabetes after initial therapy with metformin be characterized via an open collaborative research network?

Findings  In this analysis of data from more than 246 million patients in multiple cohorts, treatment with dipeptidyl peptidase 4 inhibitors compared with sulfonylureas and thiazolidinediones did not differ in reducing hemoglobin A_1c levels or hazard of kidney disorders. In a meta-analysis, sulfonylureas compared with dipeptidyl peptidase 4 inhibitors were associated with a small increased hazard of myocardial infarction and eye disorders in patients with type 2 diabetes.