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Glycemic Management in Type 2 Diabetes

Glycemic Management in Type 2 Diabetes. Efficacy and Safety of Antihyperglycemic Therapies Introduced Since 2004. Glucose Control With Sitagliptin: Selected Mono and Combination Therapy Studies.  A1C (%) . *. *. †. *.

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Glycemic Management in Type 2 Diabetes

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  1. Glycemic Management in Type 2 Diabetes Efficacy and Safety of Antihyperglycemic Therapies Introduced Since 2004

  2. Glucose Control With Sitagliptin: Selected Mono and Combination Therapy Studies  A1C (%) * * † * *P<0.001 vs active comparator monotherapy. †P<0.001 vs active comparator dual therapy. 1. Nauck MA, et al. Diabetes Obes Metab. 2007;9:194-205. 2. Goldstein BJ, et al. Diabetes Care. 2007;30:1979-1987.3. Charbonnel B, et al. Diabetes Care. 2006;29:2638-2643. 4. Vilsbøll T, et al. Diabetes Obes Metab. 2010;12:167-177.5. Derosa G, et al. Metab Clin Exp. 2010;59:887-895. 6. DobsAS, et al. J Diabetes. 2013;5:68-79..

  3. Weight Changes With Sitagliptin: Selected Mono and Combination Therapy Studies  Weight (kg) * † *P<0.001 vs glipizide; †P<0.05 vs sitagliptin. 1. Aschner P, et al. Diabetes Care. 2006;29:2632-2637. 2. Nauck MA, et al. Diabetes Obes Metab. 2007;9:194-205.3. Rosenstock J, et al. Clin Ther. 2006;28:1556-1568. 4. Hermansen K, et al. Diabetes Obes Metab. 2007;9:733-745. 5. Vilsbøll T, et al. Diabetes Obes Metab. 2010;12:167-177. 6. Derosa G, et al. Metab Clin Exp. 2010;59:887-895.

  4. Hypoglycemia With Sitagliptin:Selected Studies Patients Reporting Hypoglycemia (%) 1. Nauck MA, et al. Diabetes Obes Metab. 2007;9:194-205. 2. Goldstein BJ, et al. Diabetes Care. 2007;30:1979-1987.3. Charbonnel B, et al. Diabetes Care. 2006;29:2638-2643. 4. Rosenstock J, et al. Clin Ther. 2006;28:1556-1568.5 . Hermansen K, et al. Diabetes Obes Metab. 2007;9:733-745. 6. Vilsbøll T, et al. Diabetes Obes Metab. 2010;12:167-177.

  5. Incidence of Selected Adverse Events With Sitagliptin: Pooled Data Williams-Herman D, et al. BMC Endocr Disord. 2010;10(7) . http://www.biomedcentral.com/1472-6823/10/7.Engel SS, et al. Int J Clin Pract. 2010;64:984-990.

  6. Glucose Control With Saxagliptin:Mono and Combination Therapy  A1C (%) * * * * * P<0.0001 vs comparator. 1. Rosenstock J, et al. Curr Med Res Opin. 2009;25:2401-2411. 2. Jadzinsky M, et al. Diabetes Obes Metab. 2009;11:611-622. 3. DeFronzo RA, et al. Diabetes Care. 2009;32:1649-1655. 4. Scheen AJ, et al. Diabetes Metab Res Rev. 2010;26:540-549. 5. Chacra AR, et al. Int J Clin Pract. 2009;63:1395-1406. 6. Hollander P, et al. J Clin Endocrinol Metab. 2009;94:4810-4819.

  7. Weight Changes With Saxagliptin: Mono and Combination Therapy * Weight (kg) *P=0.01 vs glyburide uptitration. 1. Rosenstock J, et al. Curr Med Res Opin. 2009;25:2401-2411. 2. Jadzinsky M, et al. Diabetes Obes Metab. 2009;11:611-622.3. DeFronzo RA, et al. Diabetes Care. 2009;32:1649-1655. 4. Scheen AJ, et al. Diabetes Metab Res Rev. 2010;26:540-549.5. Chacra AR, et al. Int J Clin Pract. 2009;63:1395-1406. 6. Hollander P, et al. J Clin Endocrinol Metab. 2009;94:4810-4819.

  8. Hypoglycemia With Saxagliptin:Mono and Combination Therapy Patients Reporting Hypoglycemia (%) 1. Rosenstock J, et al. Curr Med Res Opin. 2009;25:2401-2411. 2. Jadzinsky M, et al. Diabetes Obes Metab. 2009;11:611-622.3. DeFronzo RA, et al. Diabetes Care. 2009;32:1649-1655. 4. Scheen AJ, et al. Diabetes Metab Res Rev. 2010;26:540-549.5. Chacra AR, et al. Int J Clin Pract. 2009;63:1395-1406. 6. Hollander P, et al. J Clin Endocrinol Metab. 2009;94:4810-4819.

  9. Incidence of Adverse Events With Saxagliptin Onglyza (saxagliptin) prescribing information. Princeton, NJ: Bristol-Meyers Squibb. 2011.

  10. Glucose Control With Linagliptin:Mono and Combination Therapy  A1C (%) * * * * † * P<0.0001 vs comparator. †P<0.0001 vs placebo and vs metformin 1000 mg twice daily. HD, high-dose metformin (1000 mg twice daily); LD, low-dose metformin (500 mg twice daily). 1. Del Prato S, et al. Diabetes Obes Metab. 2011;13:258-267. 2. Haak T, et al. Diabetes Obes Metab. 2012;14:565-574. 3. Gomis R, et al. Diabetes Obes Metab. 2011;13:653-661. 4. Taskinen MR, et al. Diabetes Obes Metab. 2011;13:65-74.5. Gallwitz B, et al. Lancet. 2012;380:475-483. 6. Owens DR, et al. Diabet Med. 2011;28:1352-61.

  11. Weight Changes With Linagliptin  Weight (kg) * * P<0.0001 vs comparator. HD, high-dose metformin (1000 mg twice daily); LD, low-dose metformin (500 mg twice daily). 1. Haak T, et al. Diabetes Obes Metab. 2012;14:565-574. 2. Gomis R, et al. Diabetes Obes Metab. 2011;13:653-661.3. Taskinen MR, et al. Diabetes Obes Metab. 2011;13:65-74. 4. Gallwitz B, et al. Lancet. 2012;380:475-483.

  12. Hypoglycemia With Linagliptin:Mono and Combination Therapy Patients Reporting Hypoglycemia (%) HD, high-dose metformin (1000 mg twice daily); LD, low-dose metformin (500 mg twice daily). 1. Del Prato S, et al. Diabetes Obes Metab. 2011;13:258-267. 2. Haak T, et al. Diabetes Obes Metab. 2012;14:565-574. 3. Gomis R, et al. Diabetes Obes Metab. 2011;13:653-661. 4. Taskinen MR, et al. Diabetes Obes Metab. 2011;13:65-74.5. Gallwitz B, et al. Lancet. 2012;380:475-483. 6. Owens DR, et al. Diabet Med. 2011;28:1352-61.

  13. Incidence of Adverse Events With Linagliptin Tradjenta (linagliptin) prescribing information. Ridgefield, CT: Boehringer Ingelheim, Inc.; 2012.

  14. Glucose Control With Alogliptin:Mono and Combination Therapy  A1C (%) * * * * * * • P<0.001 vs comparator(s). • DeFronzo RA, et al. Diabetes Care. 2008;31:2315–2317. 2. Rosenstock J, et al. Diabetes Care. 2010;33:2406–2408.3. Nauck MA, et al. Int J Clin Pract. 2009;63:46-55.4. Pratley RE, et al. Diabetes Obes Metab. 2009;11:167-176.5. Bosi E, et al. Diabetes Obes Metab. 2011;13:1088-1096. 6. Rosenstock J, et al. Diabetes Obes Metab. 2009;11:1145-1152.

  15. Weight Change With Alogliptin  Weight (kg) * • P<0.01 vs comparator. • DeFronzo RA, et al. Diabetes Care. 2008;31:2315–2317. 2. Rosenstock J, et al. Diabetes Care. 2010;33:2406–2408.3. Nauck MA, et al. Int J Clin Pract. 2009;63:46-55.4. Pratley RE, et al. Diabetes Obes Metab. 2009;11:167-176.5. Bosi E, et al. Diabetes Obes Metab. 2011;13:1088-1096. 6. Rosenstock J, et al. Diabetes Obes Metab. 2009;11:1145-1152.

  16. Hypoglycemia With Alogliptin Patients Reporting Hypoglycemia (%) • DeFronzo RA, et al. Diabetes Care. 2008;31:2315–2317. 2. Nesina (alogliptin) prescribing information. Deerfield, IL: Takeda Pharmaceuticals America, Inc.; 2013. 3.Nauck MA, et al. Int J ClinPract. 2009;63:46-55.4. Pratley RE, et al. Diabetes ObesMetab. 2009;11:167-176. 5. Bosi E, et al. Diabetes ObesMetab. 2011;13:1088-1096.6. Rosenstock J, et al. Diabetes ObesMetab. 2009;11:1145-1152.

  17. Incidence of Adverse Events With Alogliptin Nesina (alogliptin) prescribing information. Deerfield, IL: Takeda Pharmaceuticals America, Inc.; 2013.

  18. Glucose Control With Exenatide With/Without Oral Agents  A1C (%) * * * * * *P<0.001 vs comparator. †All exenatide dosages shown are 10 μg BID. 1. Moretto TJ, et al. Clin Ther. 2008;30:1448-1460 . 2. DeFronzo RA et al. Diabetes Care. 2005;28:1092-1100. 3. Buse JB, et al. Diabetes Care. 2004;27:2628-2635. 4. Zinman B, et al. Ann Intern Med. 2007;146:477-485. 5. Kendall DM et al. Diabetes Care. 2005;28:1083-1091. 6. Heine RJ, et al. Ann Intern Med. 2005;143:559-569.

  19. Weight Reduction With Exenatide: Mono and Dual Combination Therapy  Weight (kg) * * * ** * * *P<0.05 vs comparator. **P<0.0001 vs glargine. †All exenatide dosages shown are 10 μg BID. 1. Moretto TJ, et al. Clin Ther. 2008;30:1448-1460 . 2. DeFronzo RA et al. Diabetes Care. 2005;28:1092-1100. 3. Buse JB, et al. Diabetes Care. 2004;27:2628-2635. 4. Zinman B, et al. Ann Intern Med. 2007;146:477-485. 5. Kendall DM et al. Diabetes Care. 2005;28:1083-1091. 6. Heine RJ, et al. Ann Intern Med. 2005;143:559-569.

  20. Blood Pressure Changes With Exenatide  Systolic BP (mmHg) * *P<0.05 vs placebo. Moretto TJ, et al. Clin Ther. 2008;30:1448-1460.

  21. Hypoglycemia With Exenatide:Mono and Dual Combination Therapy Patients Reporting Hypoglycemia (%) †All exenatide dosages shown are 10 μg BID. 1. Moretto TJ, et al. Clin Ther. 2008;30:1448-1460 . 2. DeFronzo RA et al. Diabetes Care. 2005;28:1092-1100. 3. Buse JB, et al. Diabetes Care. 2004;27:2628-2635. 4. Zinman B, et al. Ann Intern Med. 2007;146:477-485.

  22. Exenatide: Adverse Events Byetta (exenatide) injection prescribing information. San Diego, CA: Amylin Pharmaceuticals, Inc. 2011 .

  23. Glucose Control With Liraglutide With/Without Oral Agents  A1C (%) * * * ** ** ** *** ** *P<0.0001 vs monotherapy. **P<0.0001 vs dual therapy. ***P=0.0015 vs glargine. †All liraglutide dosages shown are 1.8 mg QD. 1. Garber A, et al. Lancet. 2009;373:473-481. 2. Nauck M, et al. Diabetes Care. 2009;32:84-90. 3. Pratley RE, et al. Lancet. 2010;375:1447-1456. 4. Marre M, et al. Diabet Med. 2009;26:268-278. 5. Zinman B, et al. Diabetes Care. 2009;32:1224-1230.6. Russell-Jones D, et al. Diabetologia. 2009;52:2046-2055.

  24. Weight Reduction With Liraglutide: Mono and Dual Combination Therapy ***  Weight (kg) * * * * * * ** *P<0.0001 vs glargine, rosiglitazone, sitagliptin, or SU. **P<0.01 vs metformin. ***P<0.05 vs SU. †All liraglutide dosages shown are 1.8 mg QD. 1. Garber A, et al. Lancet. 2009;373:473-481. 2. Nauck M, et al. Diabetes Care. 2009;32:84-90. 3. Pratley RE, et al. Lancet. 2010;375:1447-1456. 4. Marre M, et al. Diabet Med. 2009;26:268-278. 5. Zinman B, et al. Diabetes Care. 2009;32:1224-1230.6. Russell-Jones D, et al. Diabetologia. 2009;52:2046-2055.

  25. Blood Pressure Changes With Liraglutide  Systolic BP (mmHg) * * * * *P<0.05 vs comparator. †All liraglutide dosages shown are 1.8 mg QD. 1. Garber A, et al. Lancet. 2009;373:473-481. 2. Nauck M, et al. Diabetes Care. 2009;32:84-90.3. Pratley RE, et al. Lancet. 2010;375:1447-1456. 4. Marre M, et al. Diabet Med. 2009;26:268-278.5. Colagiuri S, et al. Diabetes. 2008;57(suppl 2): Abstr. 554-P. 6. Zinman B, et al. Diabetes Care. 2009;32:1224-1230. 7. Russell-Jones D, et al. Diabetologia. 2009;52:2046-2055

  26. Hypoglycemia With Liraglutide:Mono and Dual Combination Therapy Patients Reporting Hypoglycemia (%) * * * *P<0.01 vs active comparator. †All liraglutide dosages shown are 1.8 mg QD. 1. Garber A, et al. Lancet. 2009;373:473-481. 2. Nauck M, et al. Diabetes Care. 2009;32:84-90. 3. Pratley RE, et al. Lancet. 2010;375:1447-1456. 4. Marre M, et al. Diabet Med. 2009;26:268-278.

  27. Liraglutide: Adverse Events Victoza (liraglutide) injection prescribing information. Princeton, NJ: Novo Nordisk Inc. 2012.

  28. Glucose Control With Exenatide ER  A1C (%) P=0.02 P=0.017 P<0.0001 P<0.01 P<0.001 *Metformin, sulfonylurea, thiazolidinedione, or combination of any 2 of these agents. †Metformin, sulfonylurea, metformin + sulfonylurea, or metformin + pioglitazone. 1. Drucker DJ, et al. Lancet. 2008;372:1240-1250. 2. Russell-Jones D, et al. Diabetes Care. 2012;35:252-258.3. Bergenstal RM, et al. Lancet. 2010;376:431-439. 4. Diamant M, et al. Lancet. 2010;375:2234-2243.5. Buse JB, et al. Lancet. 2013;381:117-124.

  29. Weight Reduction With Exenatide ER  Weight (kg) P<0.0001 P<0.001 P<0.001 *Metformin, sulfonylurea, thiazolidinedione, or combination of any 2 of these agents. †Metformin, sulfonylurea, metformin + sulfonylurea, or metformin + pioglitazone. 1. Drucker DJ, et al. Lancet. 2008;372:1240-1250. 2. Russell-Jones D, et al. Diabetes Care. 2012;35:252-258.3. Bergenstal RM, et al. Lancet. 2010;376:431-439. 4. Diamant M, et al. Lancet. 2010;375:2234-2243.5. Buse JB, et al. Lancet. 2013;381:117-124.

  30. Hypoglycemia With Exenatide ER Patients reporting hypoglycemia (%) *Metformin, sulfonylurea, thiazolidinedione, or combination of any 2 of these agents. †Metformin, sulfonylurea, metformin + sulfonylurea, or metformin + pioglitazone. 1. Drucker DJ, et al. Lancet. 2008;372:1240-1250. 2. Russell-Jones D, et al. Diabetes Care. 2012;35:252-258.3. Bergenstal RM, et al. Lancet. 2010;376:431-439. 4. Diamant M, et al. Lancet. 2010;375:2234-2243.5. Buse JB, et al. Lancet. 2013;381:117-124.

  31. Exenatide Extended Release: Adverse Events Bydureon (exenatide extended release) injection prescribing information.San Diego, CA: Amylin Pharmaceuticals, Inc. 2012.

  32. Glucose Control With Canagliflozin  A1C (%) *** ** ** ** ** ** ** † *Estimated glumerular filtration rate 30-50 mL/min/1.73 m2. **P<0.001 vs placebo. ***P<0.05 vs placebo. †Met criteria for noninferiority and superiority (upper limit of confidence interval <0.0%). 1. Stenlof K, et al. Diabetes Obes Metab. 2013;15:372-382. 2. Rosenstock J, et al. Diabetes Care. 2012;35:1232-1238.3. Schernthaner G, et al. Diabetes Care. 2013;April 5 epub ahead of print. 4. Yale J-F, et al. Diabetes Obes Metab. 2013;15:463-473.

  33. Weight Change With Canagliflozin  Weight (kg) ** † ** ** ** *Estimated glumerular filtration rate 30-50 mL/min/1.73 m2. **P<0.001 vs placebo. †P<0.001 vs sitagliptin. 1. Stenlof K, et al. Diabetes Obes Metab. 2013;15:372-382. 2. Rosenstock J, et al. Diabetes Care. 2012;35:1232-1238.3. Schernthaner G, et al. Diabetes Care. 2013;April 5 epub ahead of print. 4. Yale J-F, et al. Diabetes Obes Metab. 2013;15:463-473.

  34. Blood Pressure Change With Canagliflozin  Systolic BP (mmHg) ** ** ** *Estimated glumerular filtration rate 30-50 mL/min/1.73 m2. **P<0.001 vs comparator. 1. Stenlof K, et al. Diabetes Obes Metab. 2013;15:372-382. 2. Rosenstock J, et al. Diabetes Care. 2012;35:1232-1238.3. Schernthaner G, et al. Diabetes Care. 2013;April 5 epub ahead of print. 4. Yale J-F, et al. Diabetes Obes Metab. 2013;15:463-473.

  35. Hypoglycemia With Canagliflozin Patients reporting hypoglycemia (%) *Estimated glumerular filtration rate 30-50 mL/min/1.73 m2. **P<0.001 vs placebo. ***P<0.05 vs placebo. †Met criteria for noninferiority and superiority (upper limit of confidence interval <0.0%). 1. Stenlof K, et al. Diabetes Obes Metab. 2013;15:372-382. 2. Rosenstock J, et al. Diabetes Care. 2012;35:1232-1238.3. Schernthaner G, et al. Diabetes Care. 2013;April 5 epub ahead of print. 4. Yale J-F, et al. Diabetes Obes Metab. 2013;15:463-473.

  36. Canagliflozin: Adverse Events Invokana (canagliflozin) prescribing information. Titusville, NJ: Janssen Pharmaceuticals, Inc. 2013.

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