TY - JOUR
T1 - Metformin plus a low hypoglycemic risk antidiabetic drug vs. metformin monotherapy for untreated type 2 diabetes mellitus
T2 - A meta-analysis of randomized controlled trials
AU - Hung, Wei Tse
AU - Chen, Yuan Jung
AU - Cheng, Chun Yu
AU - Ovbiagele, Bruce
AU - Lee, Meng
AU - Hsu, Chia Yu
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/7
Y1 - 2022/7
N2 - Aims: The aim of the meta-analysis of randomized controlled trials (RCTs) was to compare the effectiveness of glycemic control and hypoglycemia risk of combination therapy (metformin plus a low hypoglycemic risk antidiabetic drug) vs. standard metformin monotherapy, in patients with untreated type 2 diabetes mellitus (T2DM). Methods: We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials through October 31, 2021 to find relevant RCTs. Efficacy outcomes were changes in hemoglobulin A1c (HbA1c) and fast plasma glucose (FPG) from baseline as well as proportion of patients achieving HbA1c < 7%; the safety outcome was hypoglycemia risk. Results: We identified 14 RCTs comprising 5326 patients with untreated T2DM. Mean treatment duration was 28.1 weeks. Pooled results showed that compared to metformin monotherapy, combination therapy was associated with a reduction in HbA1c (mean difference: −0.48 %, −0.58 to − 0.38) and FPG (mean difference: −0.92 mmol/L, −1.14 to − 0.69), and more patients achieving HbA1c < 7% (odds ratio: 2.21, 1.87 to 2.60). Hypoglycemic events and people experiencing hypoglycemia were not different between 2 groups. Conclusions: Initial combination of metformin plus a low hypoglycemic risk antidiabetic drug may achieve better glycemic control, without a rise in hypoglycemia, in patients with untreated T2DM.
AB - Aims: The aim of the meta-analysis of randomized controlled trials (RCTs) was to compare the effectiveness of glycemic control and hypoglycemia risk of combination therapy (metformin plus a low hypoglycemic risk antidiabetic drug) vs. standard metformin monotherapy, in patients with untreated type 2 diabetes mellitus (T2DM). Methods: We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials through October 31, 2021 to find relevant RCTs. Efficacy outcomes were changes in hemoglobulin A1c (HbA1c) and fast plasma glucose (FPG) from baseline as well as proportion of patients achieving HbA1c < 7%; the safety outcome was hypoglycemia risk. Results: We identified 14 RCTs comprising 5326 patients with untreated T2DM. Mean treatment duration was 28.1 weeks. Pooled results showed that compared to metformin monotherapy, combination therapy was associated with a reduction in HbA1c (mean difference: −0.48 %, −0.58 to − 0.38) and FPG (mean difference: −0.92 mmol/L, −1.14 to − 0.69), and more patients achieving HbA1c < 7% (odds ratio: 2.21, 1.87 to 2.60). Hypoglycemic events and people experiencing hypoglycemia were not different between 2 groups. Conclusions: Initial combination of metformin plus a low hypoglycemic risk antidiabetic drug may achieve better glycemic control, without a rise in hypoglycemia, in patients with untreated T2DM.
KW - Antidiabetic drugs
KW - Combination therapy
KW - Dipeptidyl peptidase-4 inhibitors
KW - Pioglitazone
KW - Sodium-glucose co-transporter-2 inhibitors
KW - Type 2 diabetes mellitus
KW - Untreated
UR - https://www.scopus.com/pages/publications/85132440491
U2 - 10.1016/j.diabres.2022.109937
DO - 10.1016/j.diabres.2022.109937
M3 - 文章
C2 - 35662614
AN - SCOPUS:85132440491
SN - 0168-8227
VL - 189
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 109937
ER -
