Evidence mapPaperPMID 25961824Full record

ReviewPloS one2015

Comparison of glucose lowering effect of metformin and acarbose in type 2 diabetes mellitus: a meta-analysis.

Shuyan Gu, Jihao Shi, Zhiliu Tang, Monika Sawhney, Huimei Hu, Lizheng Shi, Vivian Fonseca, Hengjin Dong

Open access · goldFull text readReview
In one paragraph

Review in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 5 pooled it
3.1field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 5 syntheses or guidelines pooled it, 63 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Metformin monotherapy for adults with type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2020 · on this map
    Pooled it
  6. Trial
  7. Microfluidic-based systems for the management of diabetes.Drug delivery and translational research · 2024
    Review
  8. Review
  9. Article
  10. Review
  11. Article
  12. Article
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  15. Article
  16. Metformin and Its Benefits for Various Diseases.Frontiers in endocrinology · 2020
    Review
  17. Article
  18. Review
  19. Metabolic Effects of Metformin in the Failing Heart.International journal of molecular sciences · 2018
    Review
  20. Article
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

8 authors at 4 institutions in 2 countries.

Shuyan GuCenter for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China.
Jihao ShiSir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China.
Zhiliu TangHealth Economics and Outcome Research (HEOR), Bristol-Myers Squibb, Shanghai City, China.
Monika SawhneyCollege of Health Professions, Marshall University, Huntington, West Virginia, United States of America.
Huimei HuCenter for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China.
Lizheng ShiDepartment of Global Health Systems and Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America.
Vivian FonsecaSection of Endocrinology, Department of Medicine, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
Hengjin DongCenter for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China.
Zhejiang University · CNTulane University · USMarshall University · USSir Run Run Shaw Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetformin is the first-line oral hypoglycemic agent for type 2 diabetes mellitus recommended by international guidelines. However, little information exists comparing it with acarbose which is also commonly used in China. This study expanded knowledge by combining direct and indirect evidence to ascertain the glucose lowering effects of both drugs.

methodsPubMed (1980- December 2013) and China National Knowledge Infrastructure databases (1994-January 2014) were systematically searched for eligible randomized controlled trials from Chinese and English literatures. Meta-analysis was conducted to estimate the glucose lowering effects of metformin vs. acarbose, or either of them vs. common comparators (placebo or sulphonylureas), using random- and fixed-effect models. Bucher method with indirect treatment comparison calculator was applied to convert the summary estimates from the meta-analyses into weighted-mean-difference (WMD) and 95% confidence intervals (CIs) to represent the comparative efficacy between metformin and acarbose.

resultsA total of 75 studies were included in the analysis. In direct comparison (8 trials), metformin reduced glycosylated hemoglobin (HbA1c) by 0.06% more than acarbose, with no significant difference (WMD,-0.06%; 95% CI, -0.32% to 0.20%). In indirect comparisons (67 trials), by using placebo and sulphonylureas as common comparators, metformin achieved significant HbA1c reduction than acarbose, by -0.38% (WMD,-0.38%, 95% CI, -0.736% to -0.024%) and -0.34% (WMD, -0.34%, 95% CI, -0.651% to -0.029%) respectively.

conclusionThe glucose lowering effects of metformin monotherapy and acarbose monotherapy are the same by direct comparison, while metformin is a little better by indirect comparison. This implies that the effect of metformin is at least as good as acarbose's.

Indexed as

AcarboseDiabetes Mellitus, Type 2FemaleHumansHypoglycemic AgentsMaleMetforminAcarboseHypoglycemic AgentsMetformin

Identifiers

PMID25961824
PMCPMC4427275
OpenAlexW2095938517

What Socratic holds

Textfull text, public
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.