Evaluating the Evidence behind the Novel Strategy of Early Combination from Vision to Implementation

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dc.contributor.author Paldanius, Päivi Maria
dc.date.accessioned 2021-02-19T16:28:01Z
dc.date.available 2021-02-19T16:28:01Z
dc.date.issued 2020-12
dc.identifier.citation Paldanius , P M 2020 , ' Evaluating the Evidence behind the Novel Strategy of Early Combination from Vision to Implementation ' , Diabetes & metabolism journal , vol. 44 , no. 6 , pp. 785-801 . https://doi.org/10.4093/dmj.2020.0179
dc.identifier.other PURE: 159012871
dc.identifier.other PURE UUID: 4684a5b3-3566-415f-8379-c39d6e4d5eef
dc.identifier.other WOS: 000609205900001
dc.identifier.uri http://hdl.handle.net/10138/326814
dc.description.abstract Type 2 diabetes mellitus (T2DM) is a complex and progressive chronic disease characterised by elevating hyperglycaemia and as-sociated need to gradually intensify therapy in order to achieve and maintain glycaemic control. Treating hyperglycaemia with se-quential therapy is proposed to allow holistic assessment of the efficacy and risk-to-benefit ratio of each added component. How-ever, there is an array of evidence supporting the scientific rationale for using synergistic, earlier, modern drug combinations to achieve glycaemic goals, delay the deterioration of glycaemic control, and, therefore, potentially preserve or slow down the declin-ing β-cell function. Additionally, implementation of early combination(s) may lead to opportunities to combat clinical inertia and other hurdles to optimised disease management outcomes. This review aims to discuss the latest empirical evidence for long-term clinical benefits of this novel strategy of early combination in people with newly diagnosed T2DM versus the current widely-im-plemented treatment paradigm, which focuses on control of hyperglycaemia using lifestyle interventions followed by sequentially intensified (mostly metformin-based) monotherapy. The recent reported Vildagliptin Efficacy in combination with metfoRmin For earlY treatment of T2DM (VERIFY) study results have provided significant new evidence confirming long-term glycaemic durability and tolerability of a specific early combination in the management of newly diagnosed, treatment-naïve patients world-wide. These results have also contributed to changes in clinical treatment guidelines and standards of care while clinical imple-mentation and individualised treatment decisions based on VERIFY results might face barriers beyond the existing scientific evi-dence. en
dc.format.extent 15
dc.language.iso eng
dc.relation.ispartof Diabetes & metabolism journal
dc.rights cc_by_nc
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.subject BETA-CELL FUNCTION
dc.subject TYPE-2 DIABETES-MELLITUS
dc.subject METFORMIN-TREATED PATIENTS
dc.subject INTENSIVE INSULIN THERAPY
dc.subject BLOOD-GLUCOSE CONTROL
dc.subject DRUG-NAIVE PATIENTS
dc.subject INITIAL COMBINATION
dc.subject CLINICAL INERTIA
dc.subject GLYCEMIC CONTROL
dc.subject BASAL INSULIN
dc.title Evaluating the Evidence behind the Novel Strategy of Early Combination from Vision to Implementation en
dc.type Review Article
dc.contributor.organization HUS Children and Adolescents
dc.contributor.organization Clinicum
dc.contributor.organization Children's Hospital
dc.contributor.organization Helsinki University Hospital Area
dc.contributor.organization CAMM - Research Program for Clinical and Molecular Metabolism
dc.contributor.organization Research Programs Unit
dc.contributor.organization University of Helsinki
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.4093/dmj.2020.0179
dc.relation.issn 2233-6079
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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