February 2024 

Type 2 diabetes is a very common chronic disease that reduces the quality of life and increase risk of death. Even though there is currently no cure for type 2 diabetes, there are many medications that help treat this medical condition. It is important to compare the effectiveness of these medications for type 2 diabetes. Just as important is understanding the long-term effectiveness of the medications. Dr. Bill Sivitz has been working to accomplish these goals. Dr. Sivitz is Professor Emeritus of Medicine and founding member of the FOEDRC. He is a member of the GRADE study group. GRADE stands for Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study. The GRADE study group is a collection of 36 clinics across the United States. Dr. Sivitz recently contributed to two recent GRADE publications that just appeared in Diabetes Care, a leading diabetes research journal. The work aimed at filling major gaps in knowledge by comparing 4 medications in persons with type 2 diabetes over 5 years. The medications were: 1) glargine insulin, 2) glimepiride, 3) liraglutide, and 4) sitagliptin.  As expected, all medications lowered blood sugars, as measured by hemoglobin A1c.  However, insulin glargine and liraglutide were more effective at lowering blood sugar over the 5-year period. The GRADE investigators sought to understand why these two medications had a stronger effect over time. They found that liraglutide was the most effective in slowing the decline in the function of the pancreas over time. Insulin glargine was the only medication that improved insulin sensitivity. These findings will help doctors decide which medications are best suited for their patients who have type 2 diabetes.