title: Comparative effectiveness of oral diabetes drug combinations in reducing glycosylated hemoglobin.
abstract: OBJECTIVE
  To provide evidence on the comparative effectiveness of oral diabetes drug combinations.
  
  
  METHODS
  We performed a retrospective, observational cohort study of glycosylated hemoglobin change in outpatients newly exposed to dual- or triple-drug oral diabetes treatment.
  
  
  RESULTS
  Adjusted response to a second drug added to metformin ranged from 0.85 to 1.21% glycosylated hemoglobin decline. Response to a third drug was smaller (0.53-0.91%). Higher baseline glycosylated hemoglobin was associated with larger response; sulfonylurea effectiveness declined over time; and thiazolidinediones were more effective in obese patients and women.
  
  
  CONCLUSIONS
  Observational data provide results qualitatively consistent with the limited available randomized data on diabetes drug effectiveness, and extend these findings into common clinical scenarios where randomized data are unavailable. Sex and BMI influence the comparative effectiveness of diabetes drug combinations.
authors.affiliation: Weill Cornell Medical College, 525 East 68th Street, Baker Pavilion 20th Floor, NY 10021, USA.
authors.forename: James H
authors.initials: JH
authors.lastname: Flory
authors.forename: Dylan S
authors.initials: DS
authors.lastname: Small
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Cassano
authors.forename: David J
authors.initials: DJ
authors.lastname: Brillon
authors.forename: Alvin I
authors.initials: AI
authors.lastname: Mushlin
authors.forename: Sean
authors.initials: S
authors.lastname: Hennessy
mesh_terms: D000284:Administration, Oral; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D057186:Comparative Effectiveness Research; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents