Decision on third-line type 2 diabetes medications may not be based on efficacy

Many patients want to be treated with the most effective medications, especially people who have a chronic condition like type 2 diabetes, which requires constant management. But what if all of these treatments were equally successful at controlling diabetes?

This is the case for a variety of popular third-line type 2 diabetes medications. These varieties of drugs, such as alpha-glucosidase inhibitors, thiazolidinediones, glucagon-like peptide-1 agonists, and dipeptidyl peptidase-4 inhibitors, are typically prescribed when a combination of metformin and sulfonylurea, along with healthy diet and lifestyle changes, are not enough to manage an individual's blood glucose levels.

A recent review in the journal Annals of Internal Medicine analyzed the efficacy of the aforementioned third-line medications to determine why some patients may choose one over another, according to an article published by HealthDay News.

The study's results showed that all of these drugs lowered blood sugar levels in a similar way, the news provider reported. However, the researchers highlighted the finding that some medications may pose a risk of unique side effects, such as weight gain or hypoglycemia.

They explained that since these medications are all relatively similar, the decision on what variety to use may be based on which has the least burdensome side effects for a specific patient.

For example, a person who developed type 2 diabetes because they were obese may not opt for the third-line treatment that tends to cause weight gain, the news source said.

"The choice of the third agent should be individualized according to the characteristics of the patients and the undesirable effects of the medications, so you can't elect one agent to be used in all patients with type 2 diabetes," said lead researcher Jorge Gross, quoted by the news organization.

The American Diabetes Association notes that some people with type 2 diabetes may be prescribed a combination of blood glucose-lowering medications and insulin, or insulin alone.