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Lessons Learned from the VA on Delay in Second-line Treatment for Type 2 Diabetes


Lead author of a study of nearly 200 000 adults with type 2 diabetes that revealed significant clinical inertia in the critical period following initial diagnosis expands on the implications.

Time to initiation of second-line treatment for type 2 diabetes (T2D) is getting longer while measures of HbA1c at the time of the treatment intensification are trending higher. These findings come from a study in the US Department of Veterans Affairs (VA) health system of nearly 200 000 US adults with T2D and were observed during the first 5 years after a T2D diagnosis.

In an interview with Patient Care, lead study author Sridharan Raghavan, MD, PhD, stressed that the first several years after a diabetes diagnosis are a critical period to establish glycemic control, noting that patients often are at an age where aggressive disease management poses less risk than it may in later years.

In this last part of the conversation, Dr Raghavan points out that even though the VA health care delivery system is unique, making it difficult sometimes to generalize VA research outcomes to the general public, findings from this study prove very instructive for any clinician treating patients with T2D.

For more of Patient Care's conversation with Dr Raghavan, please see:

Sridharan Raghavan, MD, PhD is an assitant professor and clinical investigator in the division of hosptial medicine, University of Colorado Denver, Anschutz Medical Campus and a clinician at the Rocky Mountain Regional Veterans Affairs Medical Center in Aurora, Colorado.

Reference: Raghavan S, Warsavage T, Liu WG, et al. Trends in timing of and glycemia at initiation of second-line type 2 diabetes treatment in US adults. Diabetes Care. Published online ahead of print March 28, 2022;dc212492.

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