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In the recently published GRADE study (a randomized trial comparing four possible second-line agents for people whose type 2 diabetes was controlled incompletely with metformin monotherapy) researchers found that liraglutide and insulin glargine were significantly, although modestly, more effective than glimepiride and sitagliptin in achieving glycemic targets after 5 years. Microvascular and cardiovascular complications were similar in all four groups (NEJM JW Gen Med Oct 15 2022 and N Engl J Med 2022; 387:1075).
Before GRADE was published, unrelated investigators analyzed data from a large U.S. Medicare claims database to try to emulate the design of the GRADE study retrospectively. About 8000 patients were identified who met GRADE inclusi…