Clinical guidelines should be updated in line with latest research discoveries
However, this study, conducted in more than 17,000 patients with type 2 diabetes and established cardiovascular disease or multiple other risk factors, demonstrated not just reduced cardiovascular disease or hospitalisation for heart failure, it also improved renal outcomes in a broad population including in the elderly. The session ended with a call for existing clinical guidelines to be updated to include these new findings.
The Vildagliptin Efficacy in Combination with Metformin For Early Treatment of Type 2 Diabetes Study, thankfully shortened to the VERIFY Study, asked three pertinent questions:
- Do those with type 2 diabetes benefit from having combined therapy at the beginning of their pharmacological treatment?
- Do those with type 2 diabetes benefit more from having combined therapy at the beginning of their pharmacological treatment compared to a sequential additive strategy? and
- Does it matter?
The primary outcome of early combination therapy for type 2 diabetes management in this study tells us that it can ensure earlier and better glycaemic control that may be more durable.
With the added benefits of a low risk of hypoglycaemia and with no increase in body weight the is the added possibility of improving patient adherence to treatment and of reducing clinical inertia and ultimately, therefore, of offering more opportunity to address individual patient needs.
The flip side of these results was that the assessment was only of one treatment option – metformin and vildagliptin - so, again, I see that, even from large clinical trials, the results always open up more questions that need to be addressed.
Ground-breaking research helping people with diabetes manage it more effectively
From there, I walk through this enormous conference centre to hear another of EASD’s prize lectures. This year’s EASD-Novo Nordisk Foundation Diabetes Prize for Excellence has been awarded to Professor Dan Drucker from the University of Toronto.
Professor Drucker’s work on gut hormones, in particular on GLP-1, has been ground-breaking and he leads us through a wide-ranging exploration of this molecule which has been one of those in the diabetes world that has made it from bench to bedside and is now an established part of the diabetes armamentarium.
It began decades ago with the discovery of GLP-1 but it progressed through basic research and into the clinic ultimately helping thousands of people living with the condition to manage it more effectively.
However, it is how Professor Drucker ends his talk that strikes me the most. “Look how far we have all come in the treatment of type 2 diabetes,” he says and he reminds us about an important anniversary.