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Type 2 Diabetes Drugs Not Effective Long Term: Study Finds

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The rising burden of type 2 diabetes is a major concern in healthcare worldwide. Type 2 diabetes is recognized as a serious public health concern with a considerable impact on human life and health expenditures.

NIH Study At-A-Glance

  • A comparison of four common drugs for treating type 2 diabetes showed that two outperformed the others in maintaining target blood sugar levels.
  • The five-year trial followed more than 5,000 people with type 2 diabetes who were already taking metformin.
  • Participants were randomly placed into one of four treatment groups. Three groups took metformin plus a medicine that increased insulin levels: sitagliptin, liraglutide, or glimepiride. The fourth group took metformin and insulin glargine U-100, a long-acting insulin.
  • Although average blood sugar levels decreased "during the study", three of four participants were unable to maintain the blood glucose target over the study period.
  • The findings offer new insights for the long-term management of type 2 diabetes.

Diabetes Globally

The number of people with type 2 diabetes worldwide has more than doubled over the past three decades. The number of people globally is projected to rise to 439 million by 2030, which represents 7.7% of the total adult population of the world aged 20–79 years.

In the United States, according to the Center for Disease Control (CDC) more than 37 million Americans have diabetes (about 1 in 10), and approximately 90-95% of them have type 2 diabetes. Type 2 diabetes most often develops in people over age 45, but more and more children, teens, and young adults are also developing it. Scientists at Tuffs University have uncovered a devastating health crisis stating that less than 7% of the U.S. adult population has good cardiometabolic health.

What is Type 2 Diabetes

Type 2 Diabetes results from insulin resistance, which happens when your blood glucose (sugar) levels are too high because the cells in your muscles, fat, and liver have stopped responding well to insulin. Insulin is a hormone produced in the pancreas, which helps convert glucose into energy. At first, the body produces more insulin to compensate, but eventually it can’t keep up with the level of resistance.

Some people with type 2 diabetes can achieve near-normal blood sugar levels with diet and exercise alone, but many also need diabetes medication or insulin therapy. The decision about which drug is best depends on many factors, including blood sugar levels and other health problems that people with type 2 diabetes have.

Diabetes Medications

The standard practice of medicine is to begin to introduce glucose medications. Diabetes medications vary widely and have different ways of working. Some medications can be given orally, while others are available as injections. The type that is suitable for the patient will be determined by the doctor. Controlling blood sugar levels is the main goal of diabetes treatment.

A drug called metformin has long been the considered the first-line medication for type 2 diabetes. Health care professionals generally recommend metformin combined with recommending diet and exercise as the best early approach to diabetes care. If blood glucose continues to become difficult to control over time even with Metformin, a second medication is often added.

But there had been no consensus regarding which medications might best be added to metformin to keep blood glucose levels in check. And it had been unclear which drugs might best protect against common side effects, such as cardiovascular disease.

The NIH Diabetes Study

To find answers, the National Institute of Health (NIH) supported a large clinical trial to directly compare four drugs often used in combination with metformin to treat type 2 diabetes. The trial was conducted at 36 study locations throughout the United States. The trial followed more than 5,000 people with type 2 diabetes who were already taking metformin. 

Participants were randomly placed into one of four treatment groups. Three groups took metformin plus a medicine that increased insulin levels: sitagliptin, liraglutide, or glimepiride. The fourth group took metformin and insulin glargine U-100, a long-acting insulin.

  • Metformin: is a drug in the Biguanide group designed to lower blood sugar levels by reducing the amount of sugar produced by the liver. 
  • Sitagliptin: Dipeptidyl peptidase-4 inhibitors or DPP-4 inhibitors are needed by the body to produce more insulin and lower blood sugar without causing hypoglycemia. Examples of other drugs in this group include allogliptin, linagliptin, saxagliptin and are most often used in combination with Metformin.
  • Liraglutide: Liraglutide is available under the following different brand name Victoza for use with type 2 diabetes. Since there is no generic brand of this drug it is very expensive, even with insurance. 
  • Glimepiride: Sulfonylureas work by stimulating beta cells in the pancreas to produce more insulin. Some other examples of these diabetes medications include gliclazide, glyburide, chlorpropamide and tolazamide.
  • Insulin glargine U-100: U-100 is an insulin injection to cover blood sugar increases, which means it can cover insulin needs for meals eaten within 30 minutes.

Findings were described in a pair of papers that appeared in the New England Journal of Medicine on September 22, 2022: N Engl J Med 2022; 387:1063-1074

NIH Study Findings

According to the NIH they concluded:

After about five years of follow-up, the researchers found that all four drugs improved blood glucose levels when added to metformin. But those taking metformin plus liraglutide or the long-acting insulin achieved and maintained their target blood levels for the longest time. They had about six months more time with blood glucose levels in the target range compared with those taking sitagliptin, the least effective in maintaining target levels.

However, none of the combinations overwhelmingly outperformed the others. Although average blood sugar levels decreased during the study, nearly three of four participants were unable to maintain the blood glucose target over the study period. This underscores the difficulty for many patients with type 2 diabetes to maintain recommended targets.

“This study was designed to provide health care providers with important information on how to guide the long-term management of type 2 diabetes,” says the study’s project scientist, Dr. Henry Burch of NIH’s National Institute of Diabetes and Digestive and Kidney Diseases. “This is an integral step toward precision medicine for diabetes care, as these results can now be used in the decision-making process for each individual patient in light of their levels of glucose control, how well the medications are tolerated, and the person’s other health considerations.”

While the study acknowledged diet and lifestyle are factors in the development and management of type 2 diabetes, it is interesting how the entire medical focus is on disease management with drugs. Their conclusion is that nearly three of four of the more than 5,000 participations were unable to maintain blood glucose targets over the 5-year period. 

The Feel Great System: Natural Solution for Type 2 Diabetes

The pharmaceutical industry and NIH continue to focus on managing blood glucose with drugs, that are clearly not working long term. What they are not acknowledging is the all-natural science-based solution for healthy blood sugar levels.

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 When you start on the Feel Great System you receive 30-day supply of two science-based food products that are back by published clinical studies, listed in the Prescribers Digital Reference (PDR) and endorsed by medical professionals throughout the world. 

The first product is Unicity Unimate yerba mate drink and the second is Unicity Balance, a fiber matrix that works by slowing the rate your body turns food into glucose. Balance effectively limits the amount of insulin needed. Instead of turning glucose into fat, your body will efficiently use the glucose for energy. To learn more about how the take the Feel Great System products to the best experience with type 2 diabetes, download the Feel Great Protocol PDF. 

What Healthcare Professionals are Saying

For more than 35 years later, Unicity Balance has been extensively studied, peer-reviewed and published in the medical journals. It continues to be the most recommended natural health supplement for type 2 diabetes by doctors and healthcare professionals worldwide.

Judy Gilman, RN stated “as a Certified Diabetes Educator I have never found anything that compares to Unicity Balance for diabetes. Being able to stabilize glucose, cholesterol and weight is a gift for people with diabetes”.

Jennifer Armendariz, RN, stated “I observe people daily struggling with diabetes, high blood pressure, and metabolic syndrome. Confidently, I have recommended over 400 people to enroll in this system. I have witnessed a life-changing results with patients, family, and friends”.

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