Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE)

The longer-term effectiveness of pharmaceuticals to treat type 2 diabetes (T2D) beyond 6-12 months is unknown. GRADE will compare the effectiveness of the 4 most commonly used therapies over 4 to 7 years in 5047 participants with T2D for up to 10 years and treated with metformin alone. Participants were randomly assigned to receive metformin plus either the sulfonylurea glimepiride, the DPP-4 inhibitor sitagliptin, the incretin liraglutide or the basal insulin glargine. The goal is to determine which combination of diabetes medications achieves best glycemic control, has the fewest side effects, and is most beneficial for overall good health.