Changing Incident Diabetes Regimens
A Veterans Administration cohort study from 2000 to 2005
- Mary Margaret Huizinga, MD12,
- Christianne L. Roumie, MD12,
- Tom A. Elasy, MD123,
- Harvey J. Murff, MD124,
- Robert Greevy, PHD15,
- Xulei Liu, MS15,
- Theodore Speroff, PHD12356 and
- Marie Griffin, MD126
- 1Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee
- 2Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee
- 3Diabetes Research and Training Center, Vanderbilt University Medical Center, Nashville, Tennessee
- 4Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
- 5Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
- 6Preventive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Address correspondence to Mary Margaret Huizinga, MD, Vanderbilt University Medical Center, 1215 21st Ave. South, 6100 Medical Center East, North Tower, Nashville, TN 37232. E-mail: mary.margaret.huizinga{at}vanderbilt.edu
Introduced in the mid-1950s, sulfonylureas have historically been the first line of treatment for type 2 diabetes (1). Metformin was introduced to the U.S. market in 1994 and has since experienced increasing market share (2). Metformin has many advantages over the sulfonylureas, including decreased weight gain and less risk of hypoglycemia (3). Despite some debate, the American Diabetes Association (ADA) recommended in 2006 that metformin be used as the first-line agent unless contraindicated (4). Whereas metformin use as a first-line agent was increasing before the ADA recommendations, no clear estimate of incident glycemic control regimens is available.
A retrospective cohort of patients …
