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J Diabetes Res. 2015;2015:129891. doi: 10.1155/2015/129891. Epub 2015 May 27.

Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2D.

Author information

1
Albert Einstein College of Medicine, Montefiore Clinical Diabetes Center, Bronx, NY 10461, USA.
2
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA.
3
Case Western Reserve University and Cleveland VA Medical Center, Cleveland, OH 44106, USA.
4
Mayo Clinic, Scottsdale, AZ 85259, USA.
5
Montreal Heart Institute, Hotel-Dieu CHUM (Centre Hospitalier de l'Université de Montréal), Montreal, QC, Canada H2W 1T8.
6
Toronto General Hospital, Toronto, ON, Canada M5G 2C4.
7
Lahey Clinic Medical Center, Burlington, MA 01805, USA.
8
University of Sao Paulo Heart Institute, 01246903 São Paulo, SP, Brazil.
9
Case Western Reserve University, Cleveland, OH 44106, USA.
10
University of Pittsburgh, Pittsburgh, PA 15260, USA.

Abstract

Glycemic management is central in prevention of small vessel and cardiovascular complications in type 2 diabetes. With the plethora of newer medications and recommendations for a patient centered approach, more information is necessary to match the proper drug to each patient. We showed that BARI 2D, a five-year trial designed to compare two different glycemic treatment strategies, was suitable for assessing different responses according to different phenotypic characteristics. Treatment with insulin sensitizing medications such as thiazolidinediones and metformin was more effective in improving glycemic control, particularly in the more insulin resistant patient, when compared to the insulin provision strategy using insulin and or sulfonylureas. Triglyceride and high density lipoprotein ratio (TG/HDL-cholesterol ratio) was found to be a readily available and practical biomarker that helps to identify the insulin resistant patient. These results support the concept that not all medications for glycemic control work the same in all patients. Thus, tailored therapy can be done using phenotypic characteristics rather than a "one-size-fits-all approach."

PMID:
26106623
PMCID:
PMC4461783
DOI:
10.1155/2015/129891
[Indexed for MEDLINE]
Free PMC Article

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