Evidence mapPaperPMID 25015317Full record

SynthesisDiabetes research and clinical practice2014

Combinational therapy with metformin and sodium-glucose cotransporter inhibitors in management of type 2 diabetes: systematic review and meta-analyses.

Qian Zhang, Jingtao Dou, Juming Lu

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Diabetes research and clinical practice, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03968224 (Effectiveness of the Treatment With Dapagliflozin and Metformin Compared to Metformin Monotherapy for Weight Loss on Diabetic and Prediabetic Patients With Obesity Class III), which is not on this map. Cited by 16 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 5 pooled it
3.2field-weighted citation impact, top 8% 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.

NCT03968224 phase2 / phase3completedstarted 2018, after this paper: background citation

Effectiveness of the Treatment With Dapagliflozin and Metformin Compared to Metformin Monotherapy for Weight Loss on Diabetic and Prediabetic Patients With Obesity Class III

Ran2018Enrolled160Registered outcomes7Posted comparisons4ConditionsDiabetes Mellitus, Type 2, Obesity, Morbid, PrediabetesArmsDapagliflozin/Metformin, Metformin
Open the trial in the graph
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 5 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Article
  7. Article
  8. ABMJ open · 2021
    Article
  9. Review
  10. Review
  11. Review
  12. Japanese Clinical Practice Guideline for Diabetes 2019.Journal of diabetes investigation · 2020
    Article
  13. Article
  14. Article
  15. Review
  16. Review
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

3 authors at 1 institution in 1 country.

Qian ZhangDepartment of Endocrinology, Chinese PLA General Hospital, Beijing, China; Chinese PLA General Hospital, Beijing, China.
Jingtao DouDepartment of Endocrinology, Chinese PLA General Hospital, Beijing, China.
Juming LuDepartment of Endocrinology, Chinese PLA General Hospital, Beijing, China. Electronic address: lujuming_301@126.com.
Chinese PLA General Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsIn search of add-on treatments to metformin, sodium-glucose cotransporter-2 (SGLT-2) inhibitors are potential candidates. This meta-analysis examines the potential use of SGLT-2 inhibitors in combination with metformin as a therapeutic option for type 2 diabetes management in patients with inadequate control with metformin.

methodsA literature search was made in several databases for randomized controlled trials (RCTs) utilizing metformin therapy combined with SGLT-2 inhibitors or placebo. Heterogeneity was estimated with I(2) statistics and random effect model was chosen for the meta-analyses of mean differences in changes from baseline in both SGLT-2 inhibitor treated and control groups.

resultsSeven RCTs were selected for the meta-analysis. In comparison with placebo-MET, the SGLT-2 inhibitor-MET combination therapy resulted in significant HbA1c decline in 12-24 week duration, to less extent after 1 year (-0.37 [-0.77, 0.03]; P=0.07) but not by 2 year (-0.41 [-1.09, 0.28]; P=0.24) duration. SGLT-2 inhibitor-MET significantly lowered FPG and body weight after 24 weeks, 1 year, and 2 years. Systolic and diastolic blood pressure declined only in the short-term (12-24 weeks). After 2 years, neither systolic (-1.80 [-6.18, 2.58]; P=0.42) nor diastolic blood pressure (-0.20 [-2.94, 2.54]; P=0.89) declined significantly more than control. Incidence of suspected genital infections was slightly more in SGLT-2 inhibitor-MET group.

conclusionSGLT-2 inhibition in combination with metformin is a potential therapeutic option based on its effects on glycemic control, body weight, and blood pressure, but further trials are required to refine this evidence.

Indexed as

Sodium-Glucose Transporter 2 InhibitorsAdultAgedBenzhydryl CompoundsBlood GlucoseBlood PressureBody WeightCanagliflozinDiabetes Mellitus, Type 2Drug Therapy, CombinationFemaleGlucosidesGlycated HemoglobinHumansHypoglycemic AgentsMaleBenzhydryl CompoundsBlood GlucoseCanagliflozindapagliflozinempagliflozinGlucosidesGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsipragliflozinMetforminSodium-Glucose Transporter 2 InhibitorsThiophenesBody mass indexChildhood obesityDiabetes mellitusInsulin sensitivityMetformin

Identifiers

PMID25015317
OpenAlexW2000068470

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.