Dr Buse’s in-depth review of the GRADE study is followed by a discussion of the keen need for more comparative research and the many new questions the results have raised about optimal T2D therapy.
"We always had the primary care providers in mind," said John Buse, MD, PhD, in an interview with Patient Care® Online. "And what I mean by that is that before a patient could be enrolled in this trial, they had to have a primary care provider, the primary care provider had to basically be on board with this four-arm randomization."
Buse is referring to the GRADE study, Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study, preliminary results of which were reported on Monday, June 28, 2021 at a virtual symposium during the American Diabetes Association 81st Scientific Sessions.
The head-to-head study of 4 classes of commonly used antihyperglycemic agents was the largest and longest study to compare efficacy of routinely prescribed second-line treatment for type 2 diabetes (T2D): a sulfonylurea, a DPP-4 inhibitor, a GLP-1 receptor agonist, and insulin glargine.
Buse, a member of the GRADE executive committee and involved since inception of the study concept, gave Patient Care a look inside the study's history and placed the preliminary findings in the context of recently expanded indications for T2D therapies. A seasoned investigator, Buse called for more head-to-head comparison studies that would help primary care physicians make more informed and more targeted T2D treatment decisions. And, he previews the many new questions the GRADE results have raised about optimal T2D therapy.
John B. Buse, MD, PhD, is Distinguished Professor, Chief, Division of Endocrinology, Director, Diabetes Center, Executive Associate Dean for Clinical Research at the University of North Carolina School of Medicine at Chapel Hill.
PLUS: "It is crazy that it is so easy to end up with a BMI of 35 in our society now. We need to have social policy that helps us prevent that."
MORE HERE, from our ADA 2021 interview with Dr John Buse on waging a focused fight against risk factors for T2D vs placing one-third of the US population on 3 drugs as first-line therapy against the disease.