Evidence mapPaperPMID 39939507Full record

ArticleClinical drug investigation2025

Dose-Dependent Relationship Between Long-Term Metformin Use and the Risk of Diabetic Retinopathy: A Population-Based Cohort Study.

Yu-Ching Li, Kuang-Hua Huang, Yih Yang, Shuo-Yan Gau, Tung-Han Tsai, Chien-Ying Lee

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Article in Clinical drug investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing 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

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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.

  1. Article
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4 · The record

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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

6 authors.

Yu-Ching Li *Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Kuang-Hua Huang *Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Yih YangDepartment of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
Shuo-Yan GauSchool of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Tung-Han TsaiDepartment of Health Services Administration, China Medical University, Taichung, Taiwan.
Chien-Ying LeeDepartment of Pharmacology, Chung Shan Medical University, 110 Jian-Guo North Road, Section 1, Taichung, 40242, Taiwan. cshd015@csmu.edu.tw.ORCID http://orcid.org/0000-0001-8159-4645

Funding

China Medical University, Taiwan CMU113-S-42Chung Shan Medical University CSMU-INT-112-02National Science and Technology Council MOST 111-2410-H-040-002
6 · The paper itself

Abstract

BACKGROUND AND

objectiveRecent research has raised concerns about the association between metformin treatment in patients with diabetes mellitus (DM) and an increased risk of diabetic retinopathy. We sought to investigate this relationship, specifically examining if metformin use affects diabetic retinopathy risk in a dose-dependent manner.

methodsThis study was a secondary data analysis based on a nationwide population database in Taiwan. Patients with new-onset DM, an age of 20 years or older, and a diagnosis of type 2 DM received at any time during 2002-2013 were included in the study. Patients diagnosed with new-onset type 2 DM between 2002 and 2013 were enrolled as the study population. We divided them into two groups: those treated with metformin and those treated with sulfonylureas. A Cox proportional hazards model was employed to estimate the risk of diabetic retinopathy after 5 years of follow-up, including cumulative defined daily dose and intensity of metformin treatment.

resultsA total of 241,231 patients received treatment with metformin, while 152,617 patients were treated with sulfonylureas. Compared with patients treated with sulfonylureas, patients who received metformin treatment, at a cumulative defined daily dose < 30, had a lower risk of diabetic retinopathy (adjusted hazard ratio = 0.77; 95% confidence interval 0.60-0.98). However, those with varying defined daily doses, especially at a higher metformin treatment level (> 25 defined daily dose), had a 2.43 times higher risk of diabetic retinopathy (95% confidence interval 1.37-4.30) compared with patients treated with sulfonylureas.

conclusionsPatients with DM treated with a lower cumulative dosage of metformin showed beneficial effects that were associated with a lower risk of diabetic retinopathy. In contrast, a higher intensity of metformin use had a greater risk of diabetic retinopathy.

Indexed as

Diabetes Mellitus, Type 2Diabetic RetinopathyHypoglycemic AgentsMetforminAdultAgedCohort StudiesDatabases, FactualDose-Response Relationship, DrugFemaleHumansMaleMiddle AgedProportional Hazards ModelsRisk FactorsSulfonylurea CompoundsHypoglycemic AgentsMetforminSulfonylurea Compounds

Identifiers

PMID39939507
PMCPMC11876261

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
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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.