Therapy for Type 2 diabetes has been around for almost 60 years, yet doctors still can’t agree on the best treatment strategy after metformin, widely viewed as the best pill to use in newly diagnosed patients. Unfortunately, many patients will need another medication in addition to metformin to get their blood sugar levels down to their goal. There are plenty of options — traditional pills that stimulate the body to make more insulin, or insulin injections themselves. Newer options include insulin-sensitizing drugs and medicines that help gastrointestinal hormones increase the insulin released from the pancreas.
Each of these classes of medications has its own unique way to reduce blood sugar and its own additional benefits, but also certain side effects. There is a lot of debate about which drug is best, with strong arguments on either side. Unfortunately, we don’t know enough about the the long-term effects of these medicines. The FDA approves diabetes drugs mainly based on their ability to lower blood sugar levels, but their effects on diabetes complications are uncertain. Experts have called for research that will allow physicians to learn more about the long-term effects of drugs for Type 2 diabetes. That’s why Yale has an ongoing study designed to answer the important question of which medicine has a better effect on Type 2 diabetes in the long term and which is better tolerated by patients.