Loading...
Evidence to guide choices among the growing array of possible second-line treatments for patients with type 2 diabetes (who have inadequate control with metformin) remains limited. Most trials of available agents have been placebo-controlled, with few direct comparisons among available drug classes. Notably, researchers in the GRADE trial compared four second-line options directly but did not include sodium-glucose cotransporter-2 (SGLT-2) inhibitors (NEJM JW Gen Med Oct 15 2022 and N Engl J Med 2022; 387:1063, 1075).
Researchers emulated a pragmatic randomized trial by using British national databases that contained information on 75,000 patients (mean age, 60) with diabetes who added SGLT-2 inhibitors, sulfonylureas, or dipeptidyl peptidas…