VA Clinical Investigator Discusses HbA1c, Comorbidities as Markers for T2D Treatment Intensification

Looking at nearly 200 000 adults with type 2 diabetes (T2D) in the US Department of Veterans Affairs (VA) health system, a research team in Colorado identified a pattern of clinical inertia over the first 5 years after a diabetes diagnosis that included delay in initiation of second-line therapy and progressive reduction in guideline-recommended surveillance of HbA1c.

In a recent interview with Patient Care, lead study author Sridharan Raghavan, MD, PhD, discussed the ongoing shift toward decisions about choice of drug for initial or intensified treatment that are based on the presence of or risk for T2D comorbidities and complications, regardless of HbA1c.

Here, Raghavan describes a future version of his study focused on timely use of glucagon-like peptide-1 mimetics and sodium-glucose cotransporter-2 inhibitors in appropriate patients.

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

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.