Evidence mapPaperPMID 18613325Full record

ArticleJournees annuelles de diabetologie de l'Hotel-Dieu2007

Metformin as first choice in oral diabetes treatment: the UKPDS experience.

R Holman

Registry-linked trialAbstract read
PubMed
In one paragraph

Article in Journees annuelles de diabetologie de l'Hotel-Dieu, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03419624 (A 28-week, Multi-center Randomized, Double-blind, Placebo-controlled Study to Evaluate the Potential of Dapagliflozin Plus Exenatide in Combination With High-dose Intensive Insulin Therapy Compared to Placebo in Obese Insulin-resistant Patients With Type 2 Diabetes Mellitus), which is not on this map. Cited by 32 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 33% 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.

NCT03419624 phase3terminatedstarted 2018, after this paper: background citation

A 28-week, Multi-center Randomized, Double-blind, Placebo-controlled Study to Evaluate the Potential of Dapagliflozin Plus Exenatide in Combination With High-dose Intensive Insulin Therapy Compared to Placebo in Obese Insulin-resistant Patients With Type 2 Diabetes Mellitus (Proof-of-concept Study)

Ran2018Enrolled13Registered outcomes7Posted comparisons0ConditionsDiabetes Mellitus, Type 2, ObesityArmsDapagliflozin 10mg, Exenatide 2 mg [Bydureon], Insulin, Metformin, if taken before, Placebo injection
Open the trial in the graph
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 1 synthesis or guideline pooled it, 89 citations in OpenAlex.

  1. Pooled it
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  19. Metformin attenuates ER stress-induced mitochondrial dysfunction.Translational research : the journal of laboratory and clinical medicine · 2017
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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

1 author at 1 institution in 1 country.

R HolmanDiabetes Trial Unit, OCDEM, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LJ, United Kingdom.
Churchill Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Metformin has been used successfully since the 1950s as first line pharmacotherapy to treat people with type 2 diabetes. It is a biguanide that decreases blood glucose concentration by mechanisms different from those of insulin secretagogues, such as sulphonylureas, or exogenous insulin therapy. Metformin lowers, rather than increases, fasting plasma insulin concentrations and acts by enhancing insulin sensitivity, inducing greater peripheral uptake of glucose, and decreasing hepatic glucose output. By reducing hepatic glucose output it lowers blood glucose and insulin levels with minimal risk of hypoglycaemia, and when used as monotherapy can lower HbAlc by around 1.5%. It is usually well tolerated, the most common side effects being gastrointestinal. Of particular value is that the improved glucose control seen with metformin is achieved without weight gain. Concerns that it may increase the risk of lactic acidosis have largely been allayed with recent studies suggesting less than one case per 100,000 treated patients. The UK Prospective Diabetes Study (UKPDS) demonstrated a substantial beneficial effect of metformin therapy on cardiovascular disease (CVD) outcomes, with a 36% relative risk reduction in all cause mortality and a 39% relative risk reduction in myocardial infarction . The first ever joint ADA (American Diabetes Association) and EASD (European Association for the Study of Diabetes) consensus guidelines on the management of hyperglycaemia in type 2 diabetes state explicitly that metformin should be used as first-line foundation therapy, in addition to lifestyle interventions.

Indexed as

Administration, OralBlood GlucoseClinical Trials as TopicDiabetes Mellitus, Type 2HumansHypoglycemic AgentsMetforminTreatment OutcomeUnited KingdomBlood GlucoseHypoglycemic AgentsMetformin

Identifiers

PMID18613325
OpenAlexW2322931379

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.