Evidence mapPaperPMID 36498669Full record

ReviewJournal of clinical medicine2022

Choice of Glucose-Lowering Drugs as Initial Monotherapy for Type 2 Diabetes Patients with Contraindications or Intolerance to Metformin: A Systematic Review and Meta-Analysis.

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

Open access · goldAbstract 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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 27% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. 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

8 authors at 5 institutions in 2 countries.

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.
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
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
Xueshan SunCenter 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.
Yuxuan GuCenter 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
Zhejiang University · CNNanjing University · CNQingdao University · CNShandong University · CNTulane University · US

Funding

Jiangsu Planning Office of Philosophy and Social Science 20JD001National Natural Science Foundation of China 72104102
6 · The paper itself

Abstract

backgroundThere are multiple glucose-lowering drugs available as alternative initial monotherapy for type 2 diabetes patients with contraindications or intolerance to metformin. However, little comparative and systematic data are available for them as initial monotherapy. This study estimated and compared the treatment effects of glucose-lowering drugs as initial monotherapy for type 2 diabetes.

methodsPubMed, Web of Science, Embase, CNKI, Chongqing VIP, and WanFang Data from 1 January 1990 until 31 December 2020 were searched for randomized controlled trials which compared a glucose-lowering drug with placebo/lifestyle-intervention for type 2 diabetes. Drug classes included metformin, sulfonylureas (SUs), thiazolidinediones (TZDs), glinides (NIDEs), α-glucosidase inhibitors (AGIs), dipeptidyl peptidase-4 inhibitors (DPP-4is), sodium-glucose cotransporter-2 inhibitors (SGLT2is), insulins (INSs), and glucagon-like peptide-1 receptor agonists (GLP-1RAs).

resultsA total of 185 trials were included, identifying 38,376 patients from 56 countries across six continents. When choosing an initial drug monotherapy alternative to metformin, SUs were most efficacious in reducing HbA1c (-1.39%; 95% CI -1.63, -1.16) and FPG (-2.70 mmol/L; 95% CI -3.18, -2.23), but increased hypoglycemia risks (5.44; 95% CI 2.11, 14.02). GLP-1RAs were most efficacious in reducing BMI (-1.05 kg/m

conclusionsOur results suggest a potential treatment hierarchy for decision-makers, with GLP-1RAs being the preferred alternative therapy to metformin regarding their favorable efficacy and safety profiles.

Indexed as

dipeptidyl peptidase-4 inhibitorsglinidesglucagon-like peptide-1 receptor agonistsinitial monotherapymetforminsodium-glucose cotransporter-2 inhibitorssulfonylureasthiazolidinedionestype 2 diabetesα-glucosidase inhibitors

Identifiers

PMID36498669
PMCPMC9740076
OpenAlexW4311014353

What Socratic holds

Textmetadata
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.