Secondary failure of metformin monotherapy in clinical practice

  • Brown J
  • Conner C
  • Nichols G
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Abstract

OBJECTIVE We sought to document the secondary failure rate of metformin monotherapy in a clinical practice setting and to explore factors that predict therapeutic failure. RESEARCH DESIGN AND METHODS We studied 1,799 type 2 diabetic patients who, between 2004 and 2006, lowered their A1C to or =7.5% or the addition or substitution of another anti-hyperglycemic agent. We used logistic regression to identify factors associated with the probability of secondary failure. RESULTS Of the 1,799 patients studied, 42% (n = 748) experienced secondary failure; the mean failure rate was 17% per year. However, patients who initiated metformin within 3 months of diabetes diagnosis failed at an age-and A1C-adjusted rate of 12.2% (10.5-14.4%) per year, and patients who initiated while A1C was

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