Oral Therapy for New-Onset Type 2 Diabetic Patients with Severe Hyperglycemia

An American Diabetes Association guideline (Diabetes Care 2016; 39 [Suppl 1]:1) recommends insulin therapy for most patients with type 2 diabetes who present initially with severe hyperglycemia (i.e., blood glucose level, ≥300 mg/dL); however, oral regimens also can be effective. In this study, researchers enrolled 100 adults with newly diagnosed type 2 diabetes, glucose levels of 300 to 450 mg/dL, and no evidence of ketoacidosis or hyperosmolar symptoms. Patients were randomized to receive one daily dose of either extended-release glipizide (10 mg) or a fixed combination of 5-mg saxagliptin plus 2000-mg metformin (Kombiglyze XR). The study was funded by the maker of Kombiglyze.

At initial diagnosis, mean glucose level was 342 mg/dL, and mea…