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Glycemic and weight changes after persistent use of incident oral diabetes therapy: a Veterans Administration

Mary Margaret Huizinga1, Christianne L Roumie, Robert A Greevy

  • 1Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.

Pharmacoepidemiology and Drug Safety
|September 30, 2010
PubMed
Abstract

Insights

Metformin and sulfonylureas offer similar glycemic control, but metformin is preferred for its positive impact on body mass index (BMI). This study highlights metformin

Area of Science:

  • Endocrinology and Metabolism
  • Pharmacology
  • Public Health

Background:

  • Systematic reviews indicate sulfonylureas and metformin match other oral antidiabetic drugs (OADs) in reducing hemoglobin A1c (A1C) within clinical trials.
  • Comparative effectiveness data for OADs in broader populations remain limited.

Purpose of the Study:

  • To compare the effectiveness of incident OAD regimens in reducing A1C.
  • To evaluate the impact of OADs on body mass index (BMI).

Main Methods:

  • Retrospective cohort study utilizing data from the Veterans Affairs Mid-South network (2001-2007).
  • Analysis included 2096 veterans with complete data for 12-month A1C and 2484 for BMI.
  • Compared metformin and sulfonylureas, controlling for demographic and clinical covariates.

Main Results:

  • Both metformin and sulfonylureas demonstrated similar reductions in A1C over 12 months.
  • Metformin use was associated with a significantly lower 12-month BMI compared to sulfonylureas (adjusted mean difference: 1.05 kg/m²).

Conclusions:

  • Metformin is recommended as a first-choice OAD due to comparable glycemic control and a beneficial effect on BMI.
  • Findings support metformin over sulfonylureas for patients where BMI management is a consideration.

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