Evidence mapPaperPMID 37362539Full record

ReviewCureus2023

A Systematic Review and Meta-Analysis of Randomized Controlled Trials Comparing the Effects of Biguanides (Metformin) and Thiazolidinediones on Glucose Tolerance and Insulin Sensitivity in Patients With Type II Diabetes Mellitus.

Hany A Zaki, Haris Iftikhar, Nabil A Shallik, Eman Shaban, Nood Dhafi R Al-Marri, Israr Bashir, Awny Elhadad, Fatma Zoghlami, Abeer Abdalrubb

Open access · diamondAbstract readReview
In one paragraph

Review in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 35% 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

4 citing papers in PubMed, 2 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
  4. 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 at 5 institutions in 3 countries.

Hany A ZakiEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Haris IftikharEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Nabil A ShallikAnaesthesiology, Weill Cornell Medical College in Qatar, Doha, QAT.
Eman ShabanCardiology, Al Jufairi Diagnosis And Treatment, Doha, QAT.
Nood Dhafi R Al-MarriEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Israr BashirEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Awny ElhadadEmergency Department, United Lincolnshire Hospitals, Lincoln, GBR.
Fatma ZoghlamiEmergency Department, Hamad General Hospital, Qatar, QAT.
Abeer AbdalrubbEndocrinology and Diabetes, Hamad Medical Corporation, Doha, QAT.
King Fahad Hospital Hufūf · SAWeill Cornell Medical College in Qatar · QAHamad General Hospital · QAHamad Medical Corporation · QAUnited Lincolnshire Hospitals NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Type II diabetes mellitus (T2DM) is a global epidemic affecting people of all ages in developed and developing countries. The disease is usually characterized by insulin resistance and glucose intolerance; therefore, oral antidiabetic drugs such as thiazolidinediones (TZDs) and biguanide metformin are used to counter these defects. Due to the varied action mechanisms of TZDs and Metformin, their effects on insulin sensitivity and glucose tolerance may differ. Therefore, the current study was carried out to compare the effects of Metformin and TZDs on insulin sensitivity and glucose tolerance among patients with T2DM. Two methods, including using a well-outlined search strategy in 5 electronic databases including ScienceDirect, Google Scholar, PubMed, Scopus, and Embase, and a manual search which involved going through the reference lists of studies from the electronic databases were used to retrieve studies published between 2000 and 2022. Additionally, data analysis of outcomes retrieved from the studies eligible for inclusion and the methodological quality was carried out using the Review Manager software (RevMan 5.4.1) and STATA. The meta-analysis has shown that TZDs have a significantly better overall effect on fasting plasma glucose (FPG) (SMD:0.61; 95% CI:0.06, 1.16: p = 0.03) and insulin sensitivity than Metformin (Mean QUICKI: 0.306 ± 0.019 vs. 0.316 ± 0.019, respectively; p=0.0003). However, the TZDs and Metformin offer the same effect on glycemic control as assessed using HBA1c levels (MD: 0.10; 95% CI: -0.20, 0.40; p = 0.52). TZDs offer better insulin sensitivity and glucose tolerance improvements compared to Metformin. This evidence contradicts the current guidelines by the American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) and the American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE), which recommend the use of Metformin as the first-line drug monotherapy for patients with T2DM.

Indexed as

biguanidediabetes mellitus (t2dm)glucose intoleranceglucose toleranceinsulin resistanceinsulin sensitivity“ metformin” “antidiabetic drugs”thiazolidinedione

Identifiers

PMID37362539
PMCPMC10289479
OpenAlexW4378070257

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.