Session moderator Dr. Daniel Einhorn, medical director of the Scripps Whittier Diabetes Institute in La Jolla, Calif., commented in an interview that Dr. Pratley “made some very cogent arguments for minimizing the number of agents used and that the counter argument more recently for multiple-agent therapy has to be looked at in the context of what insurance companies will accept and the patients can tolerate.” He agreed that sequential therapy “is perfectly reasonable” as long as it is done rapidly, meaning waiting no longer than 3 months to add needed therapy. “If you go quickly in sequential therapy, it’s like the equivalent to starting combination from the beginning,” he said.
Dr. Pratley has received research support from Lexcon, Lilly, Merck, Novo Nordisk, sanofi, and Takeda and has been a consultant for AstraZeneca, Boehringer, GlaxoSmithKline, Lilly, Merck, Novo Nordisk, sanofi, and Takeda. All his honoraria are directed toward Florida Hospital, a nonprofit organization, and Dr. Pratley does not receive direct or indirect compensation for these services.
CORRECTION: An earlier version of this article misidentified the top photo of Dr. Daniel Einhorn.