About the Study

The Glycemia Reduction Approaches in Diabetes: A Comparative
Effectiveness Study (GRADE) is a long-term study of different
treatments for type 2 diabetes.

GRADE is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health (NIH).  Type 2 diabetes is an epidemic that threatens to become the century's major public health problem and poses enormous human and economic challenges worldwide.  Most people with diabetes eventually need 2 medications to control blood glucose levels.  A major challenge is to determine which of the many
possible drugs is the best choice among people already treated with metformin, the most commonly used diabetes drug. 
GRADE will determine which combination of two
medications is best for glycemic control, has the fewest side effects, and is the most beneficial for overall health




Study Design   Participating Centers   Study News

GRADE is a randomized clinical trial of participants diagnosed with type 2 diabetes within the past 10 years who are already being treated with
.  GRADE will directly compare the 4 most commonly used types of glucose-lowering
medications (glimepiride, sitagliptin, liraglutide, and basal insulin glargine), in addition to metformin, over an average of 4 years.  
Participants will be
randomly assigned to 1 of these 4 drugs
, plus
metformin, and will be followed for up to 7 years to evaluate their relative effectiveness in achieving good glycemic control and on overall health.


36 Clinical Centers in the United States will each enroll 150 participants. The study plans to enroll 5,000 participants, and follow them up to 7 years.  9 clinical centers have
secondary locations used for recruitment and study visits.


Recruitment is underway at all 45
clinical sites, and more than 305
participants have been randomize
d into GRADE.

GRADE Study Brochure


For More Information
Please click on the map for
participating sites, or go to the study

ClinicalTrials.gov website.



Contact Information

More information on GRADE clinical sites by location is provided on the Participating Centers pageThe
interactive map has links to each individual clinical site webpage to find the site's contact information.


Press Releases

NIH news release on the GRADE study (6/03/2013)

GWU Coordinating Center press release
of the GRADE Study (9/26/2012)


Technical Support

GRADE study members should contact the GRADE webmaster with any problems logging on or
accessing documents from the website.