Findings suggest that at time of T2D diagnosis some might not benefit from metformin as first-line treatment. Dual or other therapy may be preferable. EndoTwitter
The study is also noteworthy in that it demonstrated the feasibility of using electronic health data with a machine-learning approach to discover risk biomarkers, Bielinski, professor of epidemiology at the Mayo Clinic, Rochester, Minnesota, told"We wanted to repurpose clinical data to answer questions...I think more studies using these types of techniques repurposing data meant for one thing could potentially impact care in other domains...
Overall, a total of 43% of patients met one of two criteria for metformin failure by 18 months. Among those, median time to failure on metformin was 3.9 months. Unadjusted failure rates were higher among African Americans, Hispanics, and other racial groups compared with non-Hispanic White patients. However, the racial groups also differed by baseline characteristics. Mean A1c was 7.7% overall, 8.1% for the African American group, 7.9% for Asians, and 8.2% for Hispanics, compared with 7.6% for non-Hispanic Whites.
Of 150 clinical factors examined, higher A1c was the strongest predictor of metformin failure, with a rapid increase in risk appearing between 7.5% and 8.0%.
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