0
Viewpoint |

Comparing Diabetes Medications:  Where Do We Set the Bar?

Kasia J. Lipska, MD, MHS1; Harlan M. Krumholz, MD, SM2,3,4
[+] Author Affiliations
1Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
2Section of Cardiovascular Medicine, Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
3Center for Outcomes Research and Evaluation, Yale–New Haven Hospital, New Haven, Connecticut
4Section of Health Policy and Administrations, Yale School of Public Health, New Haven, Connecticut
JAMA Intern Med. 2014;174(3):317-318. doi:10.1001/jamainternmed.2013.13433.
Text Size: A A A
Published online

Extract

More than 25 million Americans have type 2 diabetes mellitus and face decisions about which medications to use to lower glucose levels. These decisions are increasingly complex (now involving 12 different classes of glucose-lowering agents) and increasingly costly (resulting in over $18 billion in annual expenditures1). Yet, despite the enormous health and economic implications of these decisions, there are few comparative effectiveness outcomes studies to guide clinical practice. The major goals of glycemic control in type 2 diabetes are to prevent severe hyperglycemia and to reduce the risk of long-term diabetic complications, with the majority of the effort devoted to the latter. Therefore, clinicians, patients, and health systems need to know how well glucose-lowering agents (or combinations) improve the chances of living longer without cardiovascular events, painful neuropathy, kidney failure, amputation, and blindness, as well as the risks of adverse effects and other burdens of these treatments. Comparative effectiveness studies designed to assess these outcomes may not appear feasible. But what are the alternatives?

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com
brightcove.createExperiences();