Sequential Intensification of Metformin Treatment in Type 2 Diabetes With Liraglutide Followed by Randomized Addition of Basal Insulin Prompted by A1C Targets
OBJECTIVE We evaluated the addition of liraglutide to metformin in type 2 diabetes followed by intensification with basal insulin (detemir) if glycated hemoglobin (A1C) ≥7%. RESEARCH DESIGN AND METHODS In 988 participants from North America and Europe uncontrolled on metformin ± sulfonylurea, sulfonylurea was discontinued and liraglutide 1.8 mg/day added for 12 weeks (run-in). Subsequently, those with A1C ≥7% were randomized 1:1 to 26 weeks’ open-label addition of insulin detemir to metformin + liraglutide (n = 162) or continuation without insulin detemir (n = 161). Patients achieving A1C <7% continued unchanged treatment (observational arm). The primary end point was A1C change bet…
Riesgo cardiovascular en sujetos con alta probabilidad de síndrome metabólico y resistencia a la insulina. Estudio DESIRE
Introduccion y objetivos El sindrome metabolico agrupa alteraciones estrechamente relacionadas. El objetivo principal de este estudio es conocer la frecuencia del sindrome metabolico y de la resistencia a la insulina, y su papel como indicadores de riesgo cardiovascular en poblacion adulta asignada a consultas de Atencion Primaria en Espana. Metodos Sujetos ≥ 45 anos con glucemia basal ≥ 90 mg/dl y perimetro de cintura ≥ 94 cm (hombres) u 80 cm (mujeres). Se utilizaron los criterios del ATP III modificados para identificar el sindrome metabolico y el indice HOMA > 3,29 para la resistencia a la insulina. El riesgo cardiovascular se estimo mediante los modelos Framingham y SCORE. Resultados S…