Evidence mapPaperPMID 36143082Full record

ReviewJournal of clinical medicine2022

Comparison of Glucose-Lowering Drugs as Second-Line Treatment for Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Shuyan Gu, Xiaoqian Hu, Xuemei Zhen, Lizheng Shi, Hui Shao, Xueshan Sun, Yuxuan Gu, Minzhuo Huang, Hengjin Dong

Abstract readReview
In one paragraph

Review in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
field-weighted citation impact
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

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. 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

9 authors.

Shuyan GuCenter for Health Policy and Management Studies, School of Government, Nanjing University, Nanjing 210023, China.ORCID 0000-0002-2362-1251
Xiaoqian HuCollege of Politics and Public Administration, Qingdao University, Qingdao 266071, China.
Xuemei ZhenCentre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (NHC Key Laboratory of Health Economics and Policy Research), Shandong University, Jinan 250012, China.ORCID 0000-0002-1071-7326
Lizheng ShiDepartment of Global Health Management and Policy, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.ORCID 0000-0002-7827-6766
Hui ShaoDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA.
Xueshan SunCenter for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China.
Yuxuan GuCenter for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China.
Minzhuo HuangCenter for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China.
Hengjin DongCenter for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China.ORCID 0000-0002-5064-7297

Funding

National Natural Science Foundation of China 72104102
6 · The paper itself

Abstract

backgroundMultiple glucose-lowering drugs are available as add-ons to metformin for a second-line treatment for type 2 diabetes. However, no systematic and comparative data are available for them in China. We aimed to compare the effects of glucose-lowering drugs added to metformin in China.

methodsPubMed, Embase, Web of Science, CNKI, WanFang Data, and Chongqing VIP from 1 January 2000 until 31 December 2020 were systematically searched for randomized controlled trials comparing a glucose-lowering drug added to metformin with metformin in Chinese type 2 diabetes patients. Drug classes included sulfonylureas (SUs), glinides (NIDEs), thiazolidinediones (TZDs), α-glucosidase inhibitors (AGIs), dipeptidyl peptidase-4 inhibitors (DPP-4is), sodium-glucose cotransporter-2 inhibitors (SGLT2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and insulins (INSs). Two reviewers independently screened studies, extracted data, and appraised the risk of bias.

results315 trials were included. In patients receiving metformin alone, the addition of NIDEs produced the greatest additional HbA1c reductions (1.29%; 95% CI 0.97, 1.60); while INSs yielded both the largest additional FPG reductions (1.58 mmol/L; 95% CI 1.22, 1.94) and 2 hPG reductions (2.52 mmol/L; 95% CI 1.83, 3.20). INS add-ons also conferred the largest additional HDL-C increases (0.40 mmol/L; 95% CI 0.16, 0.64), whereas AGI add-ons generated the greatest TC reductions (1.08 mmol/L; 95% CI 0.78, 1.37). The greatest incremental SBP reductions (6.65 mmHg; 95% CI 4.13, 9.18) were evident with SGLT2i add-ons. GLP-1RA add-ons had the greatest BMI reductions (1.96 kg/m

conclusionThe results suggested a potential treatment hierarchy for clinicians and patients, with the GLP-1RA add-ons being most preferred based on their favorable efficacy and safety profiles; and provided a unified hierarchy of evidence for conducting country-specific cost-effectiveness analyses.

Indexed as

dipeptidyl peptidase-4 inhibitorsglinidesglucagon-like peptide-1 receptor agonistsinsulinssecond-line treatmentsodium-glucose cotransporter-2 inhibitorssulfonylureasthiazolidinedionestype 2 diabetesα-glucosidase inhibitors

Identifiers

PMID36143082
PMCPMC9504435

What Socratic holds

Textmetadata
LicenceCC BY
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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.