Evidence map›Paper›PMID 19959591›Full record

ArticleBMJ (Clinical research ed.)2009

Risk of cardiovascular disease and all cause mortality among patients with type 2 diabetes prescribed oral antidiabetes drugs: retrospective cohort study using UK general practice research database.

Ioanna Tzoulaki, Mariam Molokhia, Vasa Curcin, Mark P Little, Christopher J Millett, Anthea Ng, Robert I Hughes, Kamlesh Khunti, Martin R Wilkins, Azeem Majeed and 1 more

2 registry-linked trialsOpen access · hybridAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2009. 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 141 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
141citing papers in PubMed, 11 pooled it
24.2field-weighted citation impact, top 1% 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
PMID 18784090PMID 7895460PMID 9742977PMID 20388897PMID 15787679PMID 18955635PMID 18955637other papers from this trial
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
PMID 18784090PMID 7895460PMID 8743335PMID 16026361PMID 11225659PMID 9742977PMID 20388897PMID 9428831PMID 17145742PMID 19307526PMID 7601013PMID 14502106other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

141 citing papers in PubMed, 11 syntheses or guidelines pooled it, 441 citations in OpenAlex.

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81 more citing papers are in PubMed but not listed here.

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

11 authors at 3 institutions in 1 country.

Ioanna TzoulakiDepartment of Epidemiology and Public Health, Faculty of Medicine, Imperial College London, London W2 1PG.
Mariam Molokhia
Vasa Curcin
Mark P Little
Christopher J Millett
Anthea Ng
Robert I Hughes
Kamlesh Khunti
Martin R Wilkins
Azeem Majeed
Paul Elliott
Imperial College London · GBLondon School of Hygiene & Tropical Medicine · GBUniversity of Leicester · GB

Funding

Medical Research Council
6 · The paper itself

Abstract

objectiveTo investigate the risk of incident myocardial infarction, congestive heart failure, and all cause mortality associated with prescription of oral antidiabetes drugs.

designRetrospective cohort study.

settingUK general practice research database, 1990-2005.

participants91,521 people with diabetes.

main outcome measuresIncident myocardial infarction, congestive heart failure, and all cause mortality. Person time intervals for drug treatment were categorised by drug class, excluding non-drug intervals and intervals for insulin.

results3588 incident cases of myocardial infarction, 6900 of congestive heart failure, and 18,548 deaths occurred. Compared with metformin, monotherapy with first or second generation sulphonylureas was associated with a significant 24% to 61% excess risk for all cause mortality (P<0.001) and second generation sulphonylureas with an 18% to 30% excess risk for congestive heart failure (P=0.01 and P<0.001). The thiazolidinediones were not associated with risk of myocardial infarction; pioglitazone was associated with a significant 31% to 39% lower risk of all cause mortality (P=0.02 to P<0.001) compared with metformin. Among the thiazolidinediones, rosiglitazone was associated with a 34% to 41% higher risk of all cause mortality (P=0.14 to P=0.01) compared with pioglitazone. A large number of potential confounders were accounted for in the study; however, the possibility of residual confounding or confounding by indication (differences in prognostic factors between drug groups) cannot be excluded.

conclusionsOur findings suggest a relatively unfavourable risk profile of sulphonylureas compared with metformin for all outcomes examined. Pioglitazone was associated with reduced all cause mortality compared with metformin. Pioglitazone also had a favourable risk profile compared with rosiglitazone; although this requires replication in other studies, it may have implications for prescribing within this class of drugs.

Indexed as

Administration, OralAgedDiabetes Mellitus, Type 2Diabetic AngiopathiesFemaleFractures, BoneHeart FailureHumansHypoglycemic AgentsMaleMetforminMiddle AgedMyocardial InfarctionPioglitazoneRetrospective StudiesRisk FactorsHypoglycemic AgentsMetforminPioglitazoneRosiglitazoneSulfonylurea CompoundsThiazolidinediones

Identifiers

PMID19959591
PMCPMC2788912
OpenAlexW2171646682

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.