Dual Therapy Appears Superior to Monotherapy for Low-Income Individuals With Newly Diagnosed Type 2 Diabetes. (October 2017)

• Record Type: Journal Article
• Authors: Vaughan, Elizabeth M.; Johnston, Craig A.; Hyman, David J.; Hernandez, Daphne C.; Hemmige, Vagish; Foreyt, John P.
• Is Part Of: Journal of primary care & community health. Volume 8:Number 4(2017:Oct.)
• Page Start: 305
• Page End: 311
• Publication Date: 2017-10
• Subjects: diabetes -- low-income settings -- underserved -- chronic disease -- oral hypoglycemic agent -- community health centers -- medications -- newly diagnosed; Primary health care -- Periodicals; Primary health care -- United States -- Periodicals; Community health services -- Periodicals; Community health services -- United States -- Periodicals; 362.12
• DOI: 10.1177/2150131917745760
• Languages: English
• ISSNs: 2150-1319

Abstract

Background: There are variable recommendations regarding initiating monotherapy or dual therapy in patients with newly diagnosed type 2 diabetes (T2D). Clear initial strategies are of particular importance in underserved settings where access to care and financial burdens are significant barriers.Objectives: To provide descriptive data of metabolic outcomes to therapy regimens for low-income individuals with newly diagnosed T2D placed on oral hypoglycemic agents (OAs).Methods: We conducted a retrospective chart review of low-income individuals with newly diagnosed T2D initiated on OAs. We provided descriptive data and then evaluated the effects of OA regimens (ie, mono-, dual-, transition [from mono to dual or vice versa] therapy) on hemoglobin A1c (A1c) (baseline to 12 months).Results: A total of 309 patients were included in the study. At 12 months, the mean decrease in A1c for the entire sample was −2.36% (9.37% to 7.01%). Patients prescribed dual therapy had a greater change of A1c compared to those taking monotherapy with metformin (−1.11%, P < .01). Patients who transitioned therapies did not differ in change of A1c compared to monotherapy.Conclusion: Initiation of dual therapy was superior to metformin monotherapy or transitioning therapies and may be preferred for low-income individuals with newly diagnosed T2D.