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Abstract：
This study examines the relationship between timing of initiation on a glucagon-like peptide-1 receptor agonist (GLP-1 RA) and glycosylated hemoglobin (HbA1c) values.
The IBM MarketScan databases were used to identify adults with type 2 diabetes mellitus (T2DM) who initiated GLP-1 RA therapy and had multiple recorded HbA1c results. Time to GLP-1 RA initiation was proxied by the number of classes of glucose-lowering agents prescribed in the 2 years before GLP-1 RA initiation, with fewer glucose-lowering agents indicating initiation of a GLP-1 RA earlier in disease progression. Paired t tests examined differences in HbA1c values from preperiod to 2-year postperiod. Multivariable analyses examined the relationship between time to GLP-1 RA initiation and postperiod HbA1c values.
Initiation on a GLP-1 RA was associated with a 0.6% reduction in HbA1c values over 2 years (P < 0.0001). Earliest starts were associated with a 1.3% reduction in HbA1c levels (P < 0.0001) and the highest likelihood of achieving a postperiod HbA1c level <7% (odds ratio, 4.9; 95% CI, 3.0-8.1).
Results indicate that although initiation on a GLP-1 RA is generally associated with reduced HbA1c levels, there may be additional clinical benefits associated with earlier initiation of a GLP-1 RA.
The IBM MarketScan databases were used to identify adults with type 2 diabetes mellitus (T2DM) who initiated GLP-1 RA therapy and had multiple recorded HbA1c results. Time to GLP-1 RA initiation was proxied by the number of classes of glucose-lowering agents prescribed in the 2 years before GLP-1 RA initiation, with fewer glucose-lowering agents indicating initiation of a GLP-1 RA earlier in disease progression. Paired t tests examined differences in HbA1c values from preperiod to 2-year postperiod. Multivariable analyses examined the relationship between time to GLP-1 RA initiation and postperiod HbA1c values.
Initiation on a GLP-1 RA was associated with a 0.6% reduction in HbA1c values over 2 years (P < 0.0001). Earliest starts were associated with a 1.3% reduction in HbA1c levels (P < 0.0001) and the highest likelihood of achieving a postperiod HbA1c level <7% (odds ratio, 4.9; 95% CI, 3.0-8.1).
Results indicate that although initiation on a GLP-1 RA is generally associated with reduced HbA1c levels, there may be additional clinical benefits associated with earlier initiation of a GLP-1 RA.
摘要：
这项研究检查了胰高血糖素样肽1受体激动剂（GLP-1RA）的起始时间与糖基化血红蛋白（HbA1c）值之间的关系。
IBMMarketScan数据库用于识别2型糖尿病（T2DM）成人患者，他们开始GLP-1RA治疗，并记录了多个HbA1c结果。GLP-1RA开始的时间由GLP-1RA开始前2年内规定的降糖药种类的数量决定，降糖药物较少，表明GLP-1RA在疾病进展早期启动。配对t检验检查了从前期到2年后的HbA1c值的差异。多变量分析检查了GLP-1RA启动时间与术后HbA1c值之间的关系。
GLP-1RA的启动与2年内HbA1c值降低0.6%相关（P<0.0001）。最早的开始与HbA1c水平降低1.3%相关(P<0.0001)和达到术后HbA1c水平<7%的最高可能性(赔率比,4.9；95%CI，3.0-8.1）。
结果表明，尽管GLP-1RA的启动通常与HbA1c水平降低有关，GLP-1RA的早期启动可能会带来额外的临床获益.
IBMMarketScan数据库用于识别2型糖尿病（T2DM）成人患者，他们开始GLP-1RA治疗，并记录了多个HbA1c结果。GLP-1RA开始的时间由GLP-1RA开始前2年内规定的降糖药种类的数量决定，降糖药物较少，表明GLP-1RA在疾病进展早期启动。配对t检验检查了从前期到2年后的HbA1c值的差异。多变量分析检查了GLP-1RA启动时间与术后HbA1c值之间的关系。
GLP-1RA的启动与2年内HbA1c值降低0.6%相关（P<0.0001）。最早的开始与HbA1c水平降低1.3%相关(P<0.0001)和达到术后HbA1c水平<7%的最高可能性(赔率比,4.9；95%CI，3.0-8.1）。
结果表明，尽管GLP-1RA的启动通常与HbA1c水平降低有关，GLP-1RA的早期启动可能会带来额外的临床获益.
