VERIFY the role of initial combination therapy in patients with type 2 diabetes

Position statements by the American Diabetes Association and the European Association for the Study of Diabetes and by the American Association of Clinical Endocrinologists and American College of Endocrinology recommend sequential intensification therapy for patients recently diagnosed with diabetes and mild hyperglycaemia.1,2 A recent meta-analysis3 of 15 randomised controlled trials showed that early combination therapies were associated with greater reduction of glycaemia; however, there was heterogeneity in basal glycated haemoglobin (HbA1c) levels and median duration of follow-up was short. [...]the long-term clinical benefits of early combination therapy are still not clear. A significant reduction in the relative risk (RR) for time to initial treatment failure was observed in the early combination treatment group compared with the monotherapy group over the 5-year study duration (hazard ratio 0·51 [95% CI 0·45–0·58]; p