%0 Journal Article
%T The Relationship Between Timing of Initiation on a Glucagon-like Peptide-1 Receptor Agonist and Glycosylated Hemoglobin Values Among Patients With Type 2 Diabetes.
%A Boye KS
%A Mody R
%A Lage MJ
%A Malik RE
%J Clin Ther
%V 42
%N 9
%D 09 2020
%M 32741645
%F 3.637
%R 10.1016/j.clinthera.2020.06.019
%X 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.