ReviewTherapeutic advances in endocrinology and metabolism2021
Should metformin remain the first-line therapy for treatment of type 2 diabetes?
Review in Therapeutic advances in endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
84 citing papers in PubMed, 1 synthesis or guideline pooled it, 168 citations in OpenAlex.
- RETRACTED: Cardiovascular and mortality outcomes of DPP-4 inhibitors vs. sulfonylureas as metformin add-on therapy in patients with type 2 diabetes: A systematic review and meta-analysis.PloS one · 2025 · on this mapPooled it
- Efficacy and Safety of Glimepiride, Voglibose, and Metformin ER in Type 2 Diabetes: A Randomized, Active-Controlled Study.Journal of diabetes · 2026Trial
- Pharmacokinetics and Safety of Fixed-Dose Versus Separate Enavogliflozin/Gemigliptin Combinations, and Food Effect on Enavogliflozin in Healthy Korean Subjects.Clinical and translational science · 2025Trial
- Metabolic state determines the brain and direct islet effects of liraglutide on enhanced insulin secretion.Diabetologia · 2026Article
- Repurposing metformin for choriocarcinoma: targeting the AMPK/mTOR pathway.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Vitamin BBMJ open · 2026Article
- The AMPK/NRF2/FOXO Axis in CKD-Molecular and Clinical Perspectives.Antioxidants (Basel, Switzerland) · 2026Review
- Lipotoxicity in Diabetic Cardiomyopathy: Molecular Basis and Emerging Therapeutic Targets.International journal of molecular sciences · 2026Review
- Applications of Carbon Dots and Graphene Quantum Dots in Treatment of Diabetes.Molecules (Basel, Switzerland) · 2026Review
- Knowledge, perceptions and attitudes toward diabetes care in oncology: a pilot survey across specialties (DiaLog Study).Endocrine · 2026Article
- Phytotherapeutic Supplementation withNutrients · 2026Observational
- Article
- Exploring Autophagy Inducing Molecules: Targeting Diverse Pathways in Alzheimer's Disease Management.Medicinal research reviews · 2026Review
- Butyrate-Mediated Upregulation of Insulin Pathway Gene Expression Suggests Potential Antidiabetic Effects.Drug development research · 2025Article
- Associations of oral hypoglycemic use, fruit intake, and diabetes duration with gastrointestinal autonomic dysfunction in type 2 diabetes patients in Zanzibar.Scientific reports · 2025Article
- Diabetic cardiomyopathy: a comprehensive review of diagnosis, management, and future directions.Diabetology & metabolic syndrome · 2025Review
- The Challenges of Postoperative Tissue Flap Vitality Monitoring in Obese Individuals.Journal of clinical medicine · 2025Review
- Metformin as a potential neuroprotective agent that influence Parkinson's disease.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Are metformin-based combination approaches beneficial for non-small cell lung cancer: evidence from experimental and clinical studies.Military Medical Research · 2025Review
- Survival and Radiotherapy-Related Adverse Events in Patients Receiving Radiotherapy and Concurrent Metformin: A Systematic Review and Meta-Analysis of Randomised Controlled Trials and Cohort Studies.Pharmaceuticals (Basel, Switzerland) · 2025Review
24 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Metformin is a biguanide that is used as first-line treatment of type 2 diabetes mellitus and is effective as monotherapy and in combination with other glucose-lowering medications. It is generally well-tolerated with minimal side effects and is affordable. Although the safety and efficacy of metformin have been well-established, there is discussion regarding whether metformin should continue to be the first choice for therapy as other anti-hyperglycemic medications exhibit additional advantages in certain populations. Despite a long-standing history of metformin use, there are limited cardiovascular outcomes data for metformin. Furthermore, the available studies fail to provide strong evidence due to either small sample size or short duration. Recent data from glucagon-like peptide-1 receptor agonist and sodium-glucose cotransporter-2 inhibitor cardiovascular and renal outcomes trials demonstrated additional protection from diabetes complications for some high-risk patients, which has impacted the guidelines for diabetes management. Post-hoc analyses comparing hazard ratios for participants taking metformin at baseline
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Identifiers
What Socratic holds
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.