3 medications for type 2 diabetes may be more effective

Patients with type 2 diabetes fare significantly better if prescribed three medications at diagnosis than if given a single drug, U.S. researchers say. Dr. Ralph DeFronzo, chief of the Diabetes Division in the School of Medicine at The University of Texas Health Science Center at San Antonio, presented two-year results from 134 participants studied at University Health System's Texas Diabetes Institute. Half of the subjects received the triple-therapy regimen while the other half received the conventional treatment recommended by the American Diabetes Association. The standard regimen begins with a single agent -- metformin, adds another -- sulfonylurea -- when the first agent fails, and then adds insulin injections as needed to control blood glucose after the second agent fails. DeFronzo reported mean hemoglobin A1c, a test that strongly predicts the risk of diabetic blood vessel complications such as blindness, kidney failure, heart attacks, stroke and neuropathy, was 6 percent after 24 months in the triple-therapy group, compared to 6.6 percent in the conventional therapy group. The American Diabetes Association and the European Association for Study of Diabetes recommend a maximum hemoglobin A1c level of 6.5 percent. Forty-two percent of conventional-therapy participants failed to reach the 6.5 percent goal, but only 17 percent of the triple-therapy recipients failed to reach it, DeFronzo said. In home blood glucose monitoring, triple-therapy patients showed consistent results within the normal range, whereas patients on conventional therapy registered up and down spikes, many of which were out of the normal range, the study found. The findings were presented at the 73rd Scientific Sessions of the American Diabetes Association in Chicago.