William Herman, M.D., M.P.H., is principal investigator forĀ GRADE.

Making the grade

Large Type 2 diabetes study now enrolling

issue 21 | Spring-Summer 2014

GRADE (Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study) is an unmasked clinical trial comparing common diabetes medications in combination with metformin. The clinical study, which is now enrolling patients, seeks to ascertain long-term glycemia-lowering effectiveness and patient-centered outcomes. Patients diagnosed with Type 2 diabetes within the last 10 years, who are taking metformin alone, may be eligible.

"What differentiates GRADE from previous studies is that it will provide a head-to-head comprehensive comparison of the most commonly used drugs over a long period of time," says William Herman, M.D., M.P.H., U-M professor of Diabetes in the Division of Metabolism, Endocrinology & Diabetes (MEND). Herman is principal investigator for GRADE.

"In addition to determining which medications control blood glucose levels most effectively over time, we will examine individual factors that are associated with better or worse responses to the different medications," Herman says. "This should help us to personalize the treatment of Type 2 diabetes."

All participants will take metformin and be randomized to one of four medications approved for use with metformin: GLP-1 agonist (liraglutide); sulfonylurea (glimepiride); DPP-4 Inhibitor (sitagliptin); or long acting insulin (glargine).

Participants will have diabetes medications managed at no cost throughout the study, including four medical visits per year, but will receive other health care through their own providers. The GRADE study team will communicate regularly with the PCP while the patient is involved, providing lab and clinical results.