Should patients choose their own type 2 diabetes medication?  

Should patients choose their own type 2 diabetes medication?
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A new study has suggested that patients should be put in charge of their own type 2 diabetes medication.  

The Trimaster large-scale study is the first to allow people to choose their own type 2 diabetes medication. Patients in the trial were able to choose after trying three different drugs in succession. The authors of the study concluded that the approach could be a new way of finding the best treatment path for patients.  

Researchers from the University of Exeter led the study, which gave participants with type 2 diabetes three commonly prescribed drugs. Each participant used the drug for a 16-week period. The researchers measured the effects of each drug on the 448 patients’ glucose levels, and weight, as well as recording any side effects. 

The three drugs given to patients in the trial were sitagliptin, canagliflozin, and pioglitazone. 

Patients choose what they feel is best

After the study, patients were able to select the type 2 diabetes medication they felt worked best for them. The subsequent result showed that their chosen drug not only lowered glucose most effectively but also resulted in the fewest side effects. 

“Getting the right treatment for diabetes is fundamental to getting the best outcomes and maintaining a good quality of life. Our study is the first to invite people with type 2 diabetes to try common drugs in succession, to see which one works best for them,” said lead author Dr Beverley Shields, of the University of Exeter 

“Interestingly, we found that the treatment people chose was usually the one which gave them the best blood sugar control – even before they knew those results,” she added. 

Tim Keehner, a trial participant from North Devon, was diagnosed with type 2 diabetes 15 years ago. Keehner was included in the study because his blood sugar was frequently running too high.  

“I was given three drugs. The first two didn’t work for me at all – in fact, one of them made me feel even worse. Thankfully, from the first moment I took the third drug, I felt different – I had more energy, and I knew it was the right drug for me. I’m still on it today and I’m able to engage in all the sports I love – it’s fantastic,” testified Keehner.  

Selecting the right type 2 diabetes medication can be challenging

Over four million people in the UK are affected by type 2 diabetes. It is a major cause of death and illness and the condition accounts for 10% of all NHS expenditure. The effects of diabetes can be greatly reduced if blood sugar levels are lowered.  

There are several different drugs that work to reduce blood sugar, and while overall they are similarly effective, results in individual patients can vary in terms of how much the drug lowers their blood sugar. The frequency and severity of the side effects can also vary greatly from drug to drug. These factors make choosing the right drug for each patient difficult. 

“This is the first study in which the same patient has tried three different types of glucose-lowering drugs, enabling them to directly compare them and then choose which one is best for them,” said diabetes consultant Professor Andrew Hattersley CBE, of the University of Exeter. 

“We’ve shown that going with the patients’ choice results in better glucose control and fewer side effects than any other approach. When it’s not clear which drug is best to use, then patients should try it before they choose. Surprisingly, that approach has never been tried before,” he added.


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