TY - JOUR T1 - Secondary metformin monotherapy failure in individuals with type 2 diabetes mellitus JF - BMJ Open Diabetes Research & Care JO - BMJ Open Diab Res Care DO - 10.1136/bmjdrc-2021-002127 VL - 9 IS - 1 SP - e002127 AU - Tracey Weiss AU - Kristy Iglay AU - Tania Gulati AU - Swapnil Rajpathak AU - Lingfeng Yang AU - Lawrence Blonde Y1 - 2021/06/01 UR - http://drc.bmj.com/content/9/1/e002127.abstract N2 - Introduction To assess secondary metformin monotherapy (MM) failure in a real-world type 2 diabetes mellitus (T2DM) cohort.Research design and methods Using the IQVIA Electronic Medical Record (formerly GE Centricity) database, adults with T2DM who initiated MM between January 1, 2012 and June 30, 2016 and achieved glycemic control (hemoglobin A1c (HbA1c) <7% (53 mmol/mol); index date) were analyzed. Secondary MM failure was defined in two ways: loss of glycemic control (HbA1c ≥7% (53 mmol/mol)) and treatment change (addition or switch of antihyperglycemic agent). Multivariable logistic regression models assessed the association between secondary MM failure and sociodemographic and clinical factors.Results The analysis included 4775 patients initiating MM. 32.9% and 19.2% experienced secondary MM failure at 24 months measured as loss of glycemic control and treatment change, respectively. Multivariable logistic regression found that women (OR=1.3, 95% CI 1.1 to 1.5) compared with men, lower Charlson Comorbidity Index (CCI) (OR=0.89, 95% CI 0.86 to 0.93), and lower baseline HbA1c (OR=0.93, 95% CI 0.88 to 0.98) were associated with increased likelihood of loss of glycemic control. Lower CCI was associated with increased likelihood of treatment change (OR=0.78, 95% CI 0.75 to 0.82).Conclusions The observed frequency of secondary MM failure underscores the importance of the American Diabetes Association’s recommendation for glycemic monitoring of at least every 6 months so that timely therapeutic adjustments can be made.All data relevant to the study are included in the article or uploaded as supplementary information. Merck licensed the EMR data used in this study from IQVIA. Under its agreement with IQVIA, Merck does not have the permission to release the data to or share the data with any third party without explicit contractual consent between the third party and IQVIA. The study protocol contains the specifications of the database and details of patient selection. The study protocol is available upon request. ER -