Evidence mapPaperPMID 15787679Full record

ArticleDiabetic medicine : a journal of the British Diabetic Association2005

Reduced cardiovascular morbidity and mortality associated with metformin use in subjects with Type 2 diabetes.

J A Johnson, S H Simpson, E L Toth, S R Majumdar

2 registry-linked trialsAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Diabetic medicine : a journal of the British Diabetic Association, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 59 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 3 pooled it
5.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01386671 phase3completedstarted 2014, after this paper: background citation

Safety and Efficacy of Metformin Glycinate vs Metformin Hydrochloride on Metabolic Control and Inflammatory Mediators in Type 2 Diabetes Patients

Ran2014Enrolled203Registered outcomes13Posted comparisons0ConditionsType 2 DiabetesArmsMetformin glycinate, Metformin hydrochloride
Open the trial in the graph
NCT04943692 phase3suspendedstarted 2021, after this paper: background citation

Efficacy and Safety of Metformin Glycinate Compared to Metformin Hydrochloride on the Progression of Type 2 Diabetes

Ran2021Enrolled500Registered outcomes13Posted comparisons0ConditionsType 2 DiabetesArmsMetformin glycinate, Metformin hydrochloride
Open the trial in the graph
3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 3 syntheses or guidelines pooled it, 160 citations in OpenAlex.

  1. Pooled it
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  7. Upstream targeting for the prevention of atrial fibrillation: Targeting Risk Interventions and Metformin for Atrial Fibrillation (TRIM-AF)-rationale and study design.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
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  15. Repurposing Metformin for Vascular Disease.Current medicinal chemistry · 2023
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  18. Metformin as a Potential Agent in the Treatment of Multiple Sclerosis.International journal of molecular sciences · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

J A JohnsonInstitute of Health Economics, Edmonton, Alberta, Canada. jeff.johnson@ualberta.ca
S H Simpson
E L Toth
S R Majumdar
Institute of Health Economics · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimMetformin therapy reduces microvascular complications in Type 2 diabetes; questions remain, however, regarding its impact on macrovascular events. This study examined metformin use in relation to risk of cardiovascular-related hospitalization and mortality.

methodsWe conducted a retrospective cohort analysis, using Saskatchewan Health administrative databases to identify new users of oral antidiabetic drugs. Subject groups were defined by medication use during 1991-1999: sulphonylurea monotherapy, metformin monotherapy, or combination therapy. Deaths and non-fatal hospitalizations recorded during the study period were identified as cardiovascular-related from ICD-9 codes. The main outcome was a composite of first non-fatal hospitalization or death. Standard multivariate techniques, including propensity scores, were used to adjust for potential confounding. Multivariate Cox proportional hazard models were used to examine the relationship between metformin use and the composite endpoint.

resultsMetformin monotherapy was associated with a lower risk of the composite endpoint (adjusted hazard ratio 0.81; 95% confidence interval 0.68, 0.97) compared with sulphonylurea monotherapy. Combination therapy with meformin and a sulphonylurea was associated with lower mortality, but had similar hospitalization rates, to sulphonylurea monotherapy.

conclusionsMetformin monotherapy was associated with a lower risk of cardiovascular-related morbidity and mortality, and combination metformin and sulphonylurea therapy was associated with a reduced risk of fatal cardiovascular events, when compared with sulphonylurea monotherapy.

Indexed as

AgedAged, 80 and overDiabetes Mellitus, Type 2Diabetic AngiopathiesDrug Therapy, CombinationEpidemiologic MethodsFemaleHospitalizationHumansHypoglycemic AgentsMaleMetforminMiddle AgedSaskatchewanSulfonylurea CompoundsHypoglycemic AgentsMetforminSulfonylurea Compounds

Identifiers

PMID15787679
OpenAlexW1994294400

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.