Interview: Delay in Second-line T2D Treatment Among Younger US Veterans Sparks Investigator Concern

In a new study of nearly 200 000 US adutls with type 2 diabetes (T2D) in the US Department of Veterans Affairs health system, a Colorado-based research team observed progressive delays in initiation of second-line therapy, increases in hyperglycemia level at time of treatment intensification, and a reduction in rates of guideline-recommended HbA1c surveillance during the first 5 years after a diabetes diagnosis, a set of trends, the investigators say, that points to inreasing thereapeutic inertia in the critical early phase of treatment for T2D.

In a recent interview with Patient Care, lead study author Sridharan Raghavan, MD, PhD, details the results that he and his team found most concerning, including the temporal trend in younger individuals for whom mean HbA1c was >9% at initiation of second-line treatment.

For more of Patient Care's conversation with Dr Raghavan, please see:

• Study Author Reviews Results: Trends in Time to Initiation of Second-line T2D Treatment
• VA Clinical Investigator Discusses HbA1c, Comorbidities as Markers for T2D Treatment Intensification

Sridharan Raghavan, MD, PhD is an assitant professor and clinical investigator in the division of hosptial medicine, University of Colorado Denver, Anschutz Medical Campus and a clinician at the Rocky Mountain Regional Veterans Affairs Medical Center in Aurora, Colorado.

Reference: Raghavan S, Warsavage T, Liu WG, et al. Trends in timing of and glycemia at initiation of second-line type 2 diabetes treatment in US adults. Diabetes Care. Published online ahead of print March 28, 2022;dc212492.