PMID- 31990206
OWN - NLM
STAT- MEDLINE
DCOM- 20210311
LR  - 20221207
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 36
IP  - 5
DP  - 2020 May
TI  - Distance to glycemic goal at the time of treatment intensification in patients 
      with type 2 diabetes mellitus failing metformin monotherapy in the United States.
PG  - 741-748
LID - 10.1080/03007995.2020.1722623 [doi]
AB  - Background: A substantial proportion of patients with type 2 diabetes mellitus 
      (T2DM) do not reach their target HbA1c level on metformin. The objective of this 
      retrospective observational cohort study is to better characterize the distance 
      between HbA1c target and patient's actual HbA1c level (the distance to goal), 
      using a target HbA1c of 7.0% (53 mmol/mol), in patients with T2DM who have 
      started metformin monotherapy.Methods: We used data from the GE Centricity 
      Electronic Medical Record database by IQVIA in 2016 in the United States (US) to 
      identify adults with T2DM who started metformin monotherapy (MM) and received at 
      least 90 days of treatment. Patients were categorized into three groups: those 
      who achieved the goal of HbA1c <7.0%, those who did not achieve the goal of HbA1c 
      <7.0% (i.e. failed MM) and received intensified treatment, and those who failed 
      MM and did not receive intensified treatment. Distance to goal was computed for 
      patients in each group.Results: We identified 20,704 patients in the US database 
      who started MM; 1741 (8.4%) failed MM and received intensified treatment, while 
      4977 (24.0%) failed MM and did not receive intensified treatment. The mean 
      post-MM HbA1c for those who failed MM and received intensified treatment was 8.7% 
      (72 mmol/mol) (median 8.2%, 66 mmol/mol) and the mean distance to goal was 1.7% 
      (median 1.2%). The mean post-MM HbA1c for those who failed MM and did not receive 
      intensified treatment was 8.0% (64 mmol/mol) (median 7.5%, 58 mmol/mol) and the 
      mean distance to goal was 1.0% (median 0.5%).Conclusion: A proportion of US T2DM 
      patients do not achieve glycemic control (target HbA1c < 7.0%) despite 90 days of 
      MM. Patients who failed MM and eventually received intensified treatment did so 
      when their HbA1c distance to goal exceeded the level at which one add-on therapy 
      alone might be sufficient to bring them to goal.
FAU - Fernandes, Gail
AU  - Fernandes G
AD  - Center for Observational and Real-world Evidence, Merck and Co., Inc, Kenilworth, 
      NJ, USA.
FAU - Sawhney, Baanie
AU  - Sawhney B
AD  - Complete HEOR Solutions (CHEORS), North Wales, PA, USA.
FAU - Hannachi, Hakima
AU  - Hannachi H
AD  - Center for Observational and Real-world Evidence, Merck and Co., Inc, Kenilworth, 
      NJ, USA.
FAU - Liu, Jinan
AU  - Liu J
AD  - Center for Observational and Real-world Evidence, Merck and Co., Inc, Kenilworth, 
      NJ, USA.
FAU - Wang, Tongtong
AU  - Wang T
AD  - Center for Observational and Real-world Evidence, Merck and Co., Inc, Kenilworth, 
      NJ, USA.
FAU - Fu, Alex Z
AU  - Fu AZ
AD  - Georgetown University Medical Center, Washington DC, USA.
FAU - Iglay, Kristy
AU  - Iglay K
AD  - Center for Observational and Real-world Evidence, Merck and Co., Inc, Kenilworth, 
      NJ, USA.
FAU - McNeill, Annie
AU  - McNeill A
AD  - Center for Observational and Real-world Evidence, Merck and Co., Inc, Kenilworth, 
      NJ, USA.
FAU - Rajpathak, Swapnil
AU  - Rajpathak S
AD  - Center for Observational and Real-world Evidence, Merck and Co., Inc, Kenilworth, 
      NJ, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20200205
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (hemoglobin A1c protein, human)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Female
MH  - Glycated Hemoglobin/*analysis
MH  - Glycemic Control
MH  - Goals
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Metformin/*therapeutic use
MH  - Middle Aged
MH  - Retrospective Studies
MH  - United States
MH  - Young Adult
OTO - NOTNLM
OT  - Type 2 diabetes mellitus
OT  - glycated hemoglobin
OT  - glycemic control
OT  - metformin
OT  - treatment failure
OT  - treatment intensification
EDAT- 2020/01/29 06:00
MHDA- 2021/03/12 06:00
CRDT- 2020/01/29 06:00
PHST- 2020/01/29 06:00 [pubmed]
PHST- 2021/03/12 06:00 [medline]
PHST- 2020/01/29 06:00 [entrez]
AID - 10.1080/03007995.2020.1722623 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2020 May;36(5):741-748. doi: 10.1080/03007995.2020.1722623. 
      Epub 2020 Feb 5.