Evidence mapPaperPMID 30155646Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2018

Efficacy and Safety of Initial Combination Therapy in Treatment-Naïve Type 2 Diabetes Patients: A Systematic Review and Meta-analysis.

Xiaoling Cai, Xueying Gao, Wenjia Yang, Xueyao Han, Linong Ji

Open access · goldAbstract read
In one paragraph

Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 3 pooled it
3.1field-weighted citation impact, top 7% 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

27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Trial
  5. Review
  6. Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Treatment adherence and the contemporary approach to treating type 2 diabetes mellitus.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2024
    Review
  13. Article
  14. Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. 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

5 authors at 1 institution in 1 country.

Xiaoling CaiDepartment of Endocrine and Metabolism, Peking University People's Hospital, Beijing, China.
Xueying GaoDepartment of Endocrine and Metabolism, Peking University People's Hospital, Beijing, China.
Wenjia YangDepartment of Endocrine and Metabolism, Peking University People's Hospital, Beijing, China.
Xueyao HanDepartment of Endocrine and Metabolism, Peking University People's Hospital, Beijing, China.
Linong JiDepartment of Endocrine and Metabolism, Peking University People's Hospital, Beijing, China. prof_jilinong@aliyun.com.ORCID http://orcid.org/0000-0002-3262-2168
Peking University · CN

Funding

AstraZeneca Ltd. (China) meta-analysisFoundation for the Author of National Excellent Doctoral Dissertation of the People's Republic of China (CN) 2016YFC1304901
6 · The paper itself

Abstract

introductionThe aim of this study was to evaluate the efficacy and safety of initial combination therapy compared with monotherapy in drug-naïve type 2 diabetes patients.

methodsMEDLINE, Embase and the Cochrane Central Register of Controlled Trials were searched for randomized clinical trials of initial combination therapy with hypoglycemic agents compared with monotherapy. Those which satisfied the search criteria were included in the meta-analysis. Weighted mean difference and relative risks were calculated.

resultsA total of 36 studies were included in the meta-analysis. Compared with metformin monotherapy, initial combination therapy with metformin plus another anti-diabetes drug exhibited significant reductions in glycated hemoglobin (HbA1c) (p < 0.001). Most of the combination therapies had a similar risk of hypoglycemia (p > 0.05), with the exception of combinations of sulfonylurea/glinide and metformin or combinations of thiazolidinedione and metformin. Compared with dipeptidyl peptidase-4 (DPP-4) inhibitor monotherapy, initial combination therapy with DPP-4 inhibitor plus another anti-diabetes drug showed a significant decrease in HbA1c (p < 0.001) and a similar risk of hypoglycemia (p > 0.05). Compared with monotherapy with other anti-diabetes drugs, initial combination therapies also resulted in significant HbA1c reductions, a similar risk of hypoglycemia and similar risks of other adverse events.

conclusionCompared with monotherapy, all initial combination therapies resulted in significant HbA1c reductions. Compared with metformin monotherapy, initial combination therapies with DPP-4 inhibitors plus metformin, sodium/glucose cotransporter 2 inhibitors and metformin, respectively, were associated with similar risks of hypoglycemia, but initial combination therapies with sulfonylurea plus metformin, thiazolidinedione and metformin, respectively, were associated with higher risks of hypoglycemia.

fundingAstraZeneca Ltd. (China).

trial registrationRegistration number CRD42017060717 in PROSPERO.

Indexed as

DPP-4 inhibitorsDrug-naïveHbA1cHypoglycemiaInitial combinationMetforminSulfonylureaThiazolidinedioneType 2 diabetes

Identifiers

PMID30155646
PMCPMC6167297
OpenAlexW2889345352

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.