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KMID : 1200020210450050675
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Diabetes & Metabolism Journal
2021 Volume.45 No. 5 p.675 ~ p.683
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Efficacy and Safety of Treatment with Quadruple Oral Hypoglycemic Agents in Uncontrolled Type 2 Diabetes Mellitus: A Multi-Center, Retrospective, Observational Study
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Moon Jun-Sung
Suh Sung-Hwan
Kim Sang-Soo
Jin Heung-Yong
Kim Jeong-Mi
Jang Min-Hee
Lee Kyung-Ae
Lee Ju-Hyung
Chung Seung-Min
Lyu Young-Sang
Kim Jin-Hwa
Kim Sang-Yong
Jang Jung-Eun
Kim Tae-Nyun
Kim Sung-Woo
Jeon Eon-Ju
Cho Nan-Hee
Kim Mi-Kyung
Kim Hye-Soon
Nam-Goong Il-Seong
Kim Eun-Sook
Chung Jin-Ook
Cho Dong-Hyeok
Lee Chang-Won
Kim Young-Il
Chung Dong-Jin
Won Kyu-Chang
Kim In-Joo
Park Tae-Sun
Kim Duk-Kyu
Shon Ho-Sang
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Abstract
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Background: Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).
Methods: From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated.
Results: In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9±14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, ?1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy.
Conclusion: This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.
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KEYWORD
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Diabetes mellitus, type 2, Drug therapy, combination, Hypoglycemic agents, Injections, Insulin
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