Existing evidence is insufficient to justify metformin or other agents as first-line therapy for type 2 diabetes

Commentary on: Palmer SC, Mavridis D, Nicolucci A, et al.. Comparison of clinical outcomes and adverse events associated with glucose-lowering drugs in patients with type 2 diabetes: a meta-analysis. JAMA 2016;316:313–324 . Context A broad consensus supports the use of metformin as first-line therapy for patients with type 2 diabetes. Clinicians and patients, however, may be interested in using newer antihyperglycaemic drugs as first-line treatment, but their relative advantages to metformin—beyond burden of treatment and hypoglycaemic potential—remain uncertain. The systematic review by Palmer et al sought to evaluate the relative efficacy and safety of glucose-lowering drugs in patients with type 2 diabetes. Methods A systematic review was conducted of randomised trials testing any drug class for >24 weeks, used alone or in combination to achieve glycaemic control in adults with type 2 diabetes. The primary outcome was cardiovascular mortality. Secondary end points were patient-important outcomes (eg, all-cause...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Diabetes Therapeutics/Prevention Source Type: research