Predicting post one-year durability of glucose-lowering monotherapies in patients with newly-diagnosed type 2 diabetes mellitus – A MASTERMIND precision medicine approach (UKPDS 87)
dc.contributor.author | Agbaje, OF | |
dc.contributor.author | Coleman, RL | |
dc.contributor.author | Hattersley, AT | |
dc.contributor.author | Jones, AG | |
dc.contributor.author | Pearson, ER | |
dc.contributor.author | Shields, BM | |
dc.contributor.author | Holman, RR | |
dc.date.accessioned | 2021-01-29T09:58:35Z | |
dc.date.issued | 2020-07-21 | |
dc.description.abstract | Aims: Predicting likely durability of glucose-lowering therapies for people with type 2 diabetes (T2D) could help inform individualised therapeutic choices. Methods: We used data from UKPDS patients with newly-diagnosed T2D randomised to first-line glucose-lowering monotherapy with chlorpropamide–glibenclamide–basal insulin or metformin. In 2339 participants who achieved one-year HbA1c values <7.5% (<59 mmol/mol)–we assessed relationships between one-year characteristics and time to monotherapy-failure (HbA1c ≥ 7.5% or requiring second-line therapy). Model validation was performed using bootstrap sampling. Results: Follow-up was median (IQR) 11.0 (8.0–14.0) years. Monotherapy-failure occurred in 72%–82%–75% and 79% for those randomised to chlorpropamide–glibenclamide–basal insulin or metformin respectively–after median 4.5 (3.0–6.6)–3.7 (2.6–5.6)–4.2 (2.7–6.5) and 3.8 (2.6– 5.2) years. Time-to-monotherapy-failure was predicted primarily by HbA1c and BMI values–with other risk factors varying by type of monotherapy–with predictions to within ±2.5 years for 55%–60%–56% and 57% of the chlorpropamide–glibenclamide–basal insulin and metformin monotherapy cohorts respectively. Conclusions: Post one-year glycaemic durability can be predicted robustly in individuals with newly-diagnosed T2D who achieve HbA1c values < 7.5% one year after commencing traditional monotherapies. Such information could be used to help guide glycaemic management for individual patients. | en_GB |
dc.description.sponsorship | Medical Research Council (MRC) | en_GB |
dc.identifier.citation | Vol. 166, article 108333 | en_GB |
dc.identifier.doi | 10.1016/j.diabres.2020.108333 | |
dc.identifier.grantnumber | MR-K005707-1 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/124551 | |
dc.language.iso | en | en_GB |
dc.publisher | Elsevier / International Diabetes Federation | en_GB |
dc.rights.embargoreason | Under embargo until 21 July 2021 in compliance with publisher policy | en_GB |
dc.rights | © 2020. This version is made available under the CC-BY-NC-ND 4.0 license: https://creativecommons.org/licenses/by-nc-nd/4.0/ | en_GB |
dc.subject | Precision medicine | en_GB |
dc.subject | Modelling | en_GB |
dc.subject | Durability | en_GB |
dc.subject | Glucose-lowering agents | en_GB |
dc.subject | Monotherapy failure | en_GB |
dc.title | Predicting post one-year durability of glucose-lowering monotherapies in patients with newly-diagnosed type 2 diabetes mellitus – A MASTERMIND precision medicine approach (UKPDS 87) | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2021-01-29T09:58:35Z | |
dc.identifier.issn | 0168-8227 | |
dc.description | This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record | en_GB |
dc.identifier.journal | Diabetes Research and Clinical Practice | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | en_GB |
dcterms.dateAccepted | 2020-07-13 | |
rioxxterms.version | AM | en_GB |
rioxxterms.licenseref.startdate | 2020-07-21 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2021-01-29T09:52:40Z | |
refterms.versionFCD | AM | |
refterms.dateFOA | 2021-01-29T09:58:41Z | |
refterms.panel | A | en_GB |
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Except where otherwise noted, this item's licence is described as © 2020. This version is made available under the CC-BY-NC-ND 4.0 license: https://creativecommons.org/licenses/by-nc-nd/4.0/